ESIS ProClaim Manager, A&H

ESIS ProClaim A&H is seeking an experienced claims professional to supervise and guide a team of Claims Representatives, ensuring prompt, efficient, and fair claims services.

Key Objective:
Reporting to the AVP of Claims, the Claims Team Leader supports all aspects of third-party claim management. This role involves assigning new claims, investigating coverage, examining third-party claims, managing subrogation and recovery, determining liability, and settling claims in accordance with established best practices and client instructions. The Claims Team Leader also provides coaching, guidance, and development opportunities to the team.

Key Responsibilities:

• Supervise and support a team of claims professionals.
• Assign new claims and provide direction on policy coverage, thorough investigation, and determination of the company’s obligation to the insured, based on the line of business.
• Maintain a diary system to ensure each file is reviewed at least every 90 days.
• Provide ongoing coaching and constructive feedback to direct reports.
• Develop, monitor, and communicate performance and productivity goals.
• Review, analyze, and share performance results, productivity data, and audit/quality review outcomes.
• Ensure detailed 90-day Claim Summary Reports are prepared and provide client updates on investigations, settlement opportunities, claim denials, reservation of rights, and recommendations for claims review meetings.
• Post loss and expense reserves within authority limits and recommend reserve changes above authority to the AVP and/or VP of Claims.
• Review claim progress and status with claims leadership, discussing issues, opportunities, and remedial actions.
• Prepare and submit reports on unusual or potentially undesirable exposures, such as allegations of bad faith or unfair claim practices, to claims leadership.
• Assist claims leadership in developing improvements to claims handling procedures.
• Collaborate with Partnership Leaders to deliver results, attend meetings, and participate in claim reviews.
• Ensure claims professionals obtain appropriate releases, proofs of loss, or compensation agreements, and issue company payments for claims.
• Maintain accurate and complete claim files, including notes, reports, photos, and documentation.
• Adhere to all company policies and regulatory compliance requirements.

• Minimum of 5 years’ experience as a claims professional or in claims management, with advanced technical expertise in handling Accident and Health or Travel claims.
• Possession of a P&C insurance adjuster license, where required.
• Strong knowledge of insurance industry concepts, claims handling practices, and procedures.
• Proven experience managing complex coverage matters.
• Solid understanding of insurance fundamentals and legal principles.
• Familiarity with P&C group coverage and related services.
• Working knowledge of industry best practices and procedures.
• Demonstrated ability to work independently.
• Excellent interpersonal, communication, and negotiation skills, with the ability to interact professionally with customers and business partners.
• Ability to make prompt, well-reasoned decisions based on thorough analysis of complex issues.

The pay range for the role is $90,000 to $130,000. 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.

ESIS, a multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides a full range of sophisticated risk management services, including workers compensation claims handling; a broad spectrum of casualty insurance products, such as general liability, automobile liability, products liability, professional liability, and medical malpractice claims handling; and disability management. 

ESIS Specialty continually monitors, measures, and analyzes trends while working closely with clients to identify opportunities to positively impact their program costs. ESIS Specialty applies a balanced approach to claims handling and management and continually refines approach to be sure services are customized, complementary and complete.

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.