Claim Examiner

JOB DESCRIPTION

Chubb is currently seeking a Workers’ Compensation Lost Time Claim Examiner for our Los Angeles office. The successful applicant will be handling claims for CA jurisdiction. The position will report to and reside in our Los Angeles office.

Duties & Responsibilities:

• Handles all aspects of workers’ compensation lost time claims from set-up to case closure, ensuring strong customer relations are maintained throughout the process.
• Reviews claim and policy information to provide background for the investigation.
• Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with the insured, claimant, and medical providers.
• Evaluates the facts gathered through the investigation to determine the compensability of the claim.
• Informs insureds, claimants, and attorneys of claim denials when applicable.
• Prepares reports on investigation, settlements, denials of claims, evaluations of involved parties, etc.
• Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
• Sets reserves within authority limits for medical, indemnity, and expenses and recommends reserve changes to Team Leader throughout the life of the claim.
• Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
• Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
• Works with attorneys to manage hearings and litigation
• Controls and directs vendors, nurse case managers, telephonic case managers, and rehabilitation managers on medical management and return-to-work initiatives.
• Complies with customer service requests, including special claims handling procedures, file status notes, and claim reviews.
• File workers’ compensation forms and electronic data with states to ensure compliance with statutory regulations.
• Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
• Works with in-house Technical Assistants, Special Investigators, and nurses
  Consultants, telephonic case managers, and Team Supervisors to exceed customer’s expectations for exceptional claims handling service.

Technical Skills & Competencies:

• Lost Time Claim Examiner position with prior experience in workers’ compensation lost time adjusting or as a medical only examiner or similar examiner experience in short-term / long-term disability, auto personal injury protection, medical injury, general liability, or as a claim technical assistant for lost time claims.
• Requires knowledge of workers’ compensation statutes, regulations, and compliance.
• Ability to incorporate data analytics and modeling into daily activities to expedite the fair and equitable resolution of claims and claim issues.
• Exceptional customer service and focus.
• Ability to openly collaborate with leadership and peers to accomplish goals.
• Demonstrates a commitment to a career in claims.
• Exceptional time management and multi-tasking capabilities with consistent follow-through to meet deadlines.
• Use analytical skills to find mutually beneficial solutions to claims and customer issues.
• Ability to prepare and make exceptional presentations to internal and external customers.
• Conscientious about the quality and professionalism of work product and
  relationships with co-workers and clients.
• Willing to take ownership and tackle obstacles to meet Chubb’s quality
  standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation.
• Superior verbal and written communication skills.

Experience, Education, & Requirements:

• Experience working in a customer-focused, fast-paced, fluid environment
• Experience utilizing strong communication and telephonic skills
• Prior experience requiring a high level of organization, follow-up and accountability
• Prior workers’ compensation claim handling experience is a plus but not required
• Familiarity with claim handling (healthcare, short-term / long-term disability, auto personal injury protection, medical injury, or general liability) is a plus but not required
• Prior insurance, legal or corporate business experience is a plus but not required
• AIC, RMA, or CPCU-completed coursework or designation(s) is a plus but not required
• Proficiency with Microsoft Office Products
• Knowledge of medical terminology is a plus but not required
• Knowledge of bill processing is a plus but not required
• Certicifation to handle CA Workers Compensation claims is required
• Experience handling claims in the states of CO, UT, NV and AZ preferred
• If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.
• Proficiency with Microsoft Office Products

The pay range for the role is $62,200 to $105,800. The specific offer will depend on an applicant’s skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.

ABOUT US

Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.
Accommodations will be made available for eligible job seekers
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