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Workers' Compensation Lost Time Sr. Claims Examiner job in Jersey City at Chubb INA Holdings Inc.

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Workers' Compensation Lost Time Sr. Claims Examiner at Chubb INA Holdings Inc.

Workers' Compensation Lost Time Sr. Claims Examiner

Chubb INA Holdings Inc. Jersey City, NJ Full Time

Chubb is the world’s largest publicly traded property and casualty insurer. 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. 

 Chubb is currently seeking a Workers’ Compensation Lost Time Claim Director for our Northeast, New York, and New Jersey Region.  The successful applicant will be handling claims from Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, and New Jersey.  The position will report to a Claim Manager and reside in either our New Haven, Connecticut, Basking Ridge, New Jersey or Jersey City, New Jersey office.  
Duties & Responsibilities:

  • Handles the largest, most complex workers’ compensation lost time claims
  • Requires minimal oversight to independently handle all aspects of workers’ compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process
  • Works with Manager and Regional Executive Claim Director on complex matters
  • Provides direct updates to Regional Executive Claim Director on claims being directly handled
  • Serves as a subject matter expert for the department
  • Provides project management on regional initiatives
  • Provides backup to Manager during PTOs
  • Reviews claim and policy information to provide background for investigation
  • Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers 
  • Evaluates the facts gathered through the investigation to determine compensability of the claim
  • Informs insureds, claimants, and attorneys of claim denials when applicable
  • Prepares reports on investigation, settlements, denials of claims and 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 cases 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
  • Files workers’ compensation forms and electronic data with states to ensure compliance with statutory regulations

Technical Skills & Competencies:

  • Prior experience as a Lost Time Claim Examiner
  • Works with autonomy and showcases venue expertise
  • Serves as a mentor and leader to staff at all levels
  • Utilizes influence management skills to drive results, consistency amongst peers and as motivation
  • Provides project management
  • Serves as a subject matter expert for all venues on workers’ compensation statutes, regulations, and compliance matters
  • Ability to incorporate data analytics and modeling into daily activities to expedite 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 claim 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:

  • 8 plus years of prior Workers’ Compensation Lost Time claim handling experience
  • Experience working in a customer focused, fast-paced, fluid environment
  • Experience utilizing strong communication and telephonic skills
  • Prior experience demonstrating a high level of organization, follow-up, and accountability 
  • AIC, RMA, or CPCU completed coursework or designation(s) is a plus but not required
  • Experience with litigation management
  • Experience with subrogation investigations
  • Experience with fraud investigations
  • Experience with medical case management
  • Knowledge of medical terminology
  • Conduct reserve analyses to ensure adequacy and demonstrate financial acumen
  • Claim Adjuster licenses in Connecticut, New Hampshire, Rhode Island, and Vermont, are necessary; however, they are not required at the time of posting for the position. 
    • Applicants will have 180 days from date-of-hire to acquire the necessary licenses if selected for the position.
  • Proficiency with Microsoft Office Products

Chubb offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, a generous retirement savings plan, disability coverage, stock purchase plan, flexible spending accounts, tuition reimbursement, and business casual dress. 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, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.

EEO Statement

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. 


Recommended Skills

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