Claims Representative

Chubb

New Haven, CT

On-siteCareer-pivot friendly

Who this role is best for

Aimed at mid-level claim professionals who can manage workers’ compensation medical claims and collaborate with cross-functional teams.

Best fit for

Candidates with prior claim handling experience in workers’ compensation or related fields
— “Prior workers’ compensation claim handling experience is a plus but not required”
Individuals who can manage multiple tasks and meet deadlines in a fast-paced setting
— “Ability to multi-task with proven time management skills to meet deadlines”
Professionals who can communicate clearly and professionally over the phone
— “Superior telephonic skills”

Things to consider

Must obtain specific claim adjuster licenses within three months of hire if not already in place
— “If any applicant does not have the required licenses, in current standing, the applicant will have three (3) attempts or three (3) months, whichever is sooner, from the date-of-hire, to acquire the necessary licenses.”
The role involves handling claims across multiple states, requiring familiarity with regional regulations
— “Handles claims from Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, and New Jersey.”

How to stand out

Highlight experience with claim investigations and medical management processes
— “Conducts three-part ongoing investigations, obtaining facts and taking statements as necessary”
Emphasize your ability to prepare detailed reports and communicate findings effectively
— “Prepares reports on investigations, settlements, denials of claims, evaluations of involved parties, etc.”
Demonstrate your understanding of workers’ compensation statutes and compliance procedures
— “Knowledge of insurance, claims, and workers’ compensation statutes, regulations, and compliance is a plus”
Demonstrate experience working with vendors and managing telephonic case managers
— “Controls and directs vendors, nurse case managers, and telephonic case managers on medical management.”

Pace · Fast PacedCollaboration · HighAutonomy · MediumDecision Impact · Team

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

maintain strong customer relations
set reserves within authority limits
control and direct vendors
comply with statutory regulations

Typical background

claims handling experiencecustomer service experience

Skills & requirements

Required

Claims HandlingCustomer ServiceTelephonic SkillsOrganizational SkillsTime ManagementTeamworkCommunication Skills

Preferred

Data AnalyticsModeling

Stack & domain

InsuranceClaimsWorkers’ CompensationData AnalyticsModelingTelephonic SkillsOrganizational SkillsTime ManagementTeamworkCritical ThinkingDecision-makingVerbal CommunicationWritten CommunicationLeadershipCommunicationNullHealthcare

About the role

Original posting from Chubb

Chubb is currently seeking a Workers’ Compensation Medical Only Claim Representative 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, and reside in, our New Haven, Connecticut office.
Duties & Responsibilities:
Handles all aspects of workers’ compensation medical only 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 three-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 medical treatment.
Inform insureds and claimants of claim denials when applicable.
Prepares reports on investigations, settlements, denials of claims, evaluations of involved parties, etc.
Timely administration of statutory medical only benefits throughout the life of the claim.
Sets reserves within authority limits for medical 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.
Controls and directs vendors, nurse case managers, and telephonic case managers on medical management.
Complies with customer service requests, including Special Claims Handling procedures and file status notes.
Submits workers’ compensation forms and electronic data to 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, Nurse
Consultants, Telephonic Case Managers and Team Supervisors to exceed customers' expectations for exceptional claim handling service.
Technical Skills & Competencies:
Knowledge of insurance, claims, and workers’ compensation statutes, regulations, and compliance is a plus, but on-the-job training will be provided to the chosen applicant.
Ability to incorporate data analytics and modeling into daily activities to expedite the fair and equitable resolution of claims and claim issues.
A personal commitment to superior performance that adds value to our company and our customers.
Ability to work effectively with a wide variety of people.
An aptitude for evaluating, analyzing, and interpreting information.
Superior telephonic skills.
Excellent organizational skills.
The ability to multi-task with proven time management skills to meet deadlines.
Ability to work well in teams.
Demonstrate critical thinking and decision-making ability.
Excellent 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, medical billing, 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
Claim adjuster licenses in Connecticut (all casualty lines), New Hampshire (workers’ compensation), Rhode Island (workers’ compensation), and Vermont (workers’ compensation) are required.
If any applicant does not have the required licenses, in current standing, the applicant will have three (3) attempts or three (3) months, whichever is sooner, from the date-of-hire, to acquire the necessary licenses.
Proficiency with Microsoft Office Products
The pay range for the role is $57,200 to $80,300. 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.
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.

Source: Chubb careers