ESIS Senior Claims Representative, WC

JOB DESCRIPTION

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need.

At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team.

If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

ESIS is seeking an experienced workers' compensation claims representative for the Las Vegas, NV office.

The person in this role will handle and maintain all workers' compensation claims and file reviews under the general supervision of a supervisor and as part of the ESIS team.

Minimum Responsibilities:

Qualified candidates must possess experience in managing workers' compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation.Experience in a third-party administrator (TPA) environment is a plus.

Knowledge of NV Workers' Compensation laws and procedures is required.

Candidates must have the ability to work independently while assimilating various technical subjects, as evidenced by successful completion of a college degree or equivalent practical work experience.AIC/CPCU is preferred, and candidates must also have solid computer software skills (M/S Word, Excel).

SPECIFIC RESPONSIBILITIES:


* Determine initial reserves and provide direction to representatives as needed, identifying issues with compensability, medical conditions, subrogation, etc.


* Ensure that all coding and documentation are appropriate.


* Follow files according to diaries established by the system as well as individual claim file diaries based on the complexity of the file or customer agreements.


* Complete status reports for accounts as needed and participate in file reviews as required.


* Ensure reserve adequacy in compliance with ESIS and carrier requirements.


* Participate in litigation strategy sessions.


* Review and correct a variety of internal documents (reserves, appeals, internal audit requirements, SAS 70, etc.), sometimes completing them personally.


* Participate in the strategy and management of catastrophic injuries, collaborating with accounts, nurses, representatives, claims vice presidents, the home office, carriers, etc.


* Resolve concerns from customers, claimants, brokers, or carriers


* Manage the closing of cases to ensure they move quickly and accurately.

QUALIFICATIONS



* Ability

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