About the position
ESIS is currently seeking a Claims Trainee to join our team. This position is designed for individuals who are eager to build a successful career in a dynamic and diverse organization. Applicants with a Bachelor's degree, Master's degree, or equivalent experience are encouraged to apply. The program provides hands-on business training and interactive instruction that will prepare trainees for a rewarding career as a Workers' Compensation Claims representative. As a Claims Trainee, you will be under close supervision, reviewing claims and policy information to gather necessary background for investigation and determine the extent of the insurer's liability based on the line of business. You will conduct interviews and obtain statements from insured individuals, claimants, witnesses, medical professionals, attorneys, and police officers to gather essential claim information. Evaluating the information collected during investigations will be crucial to determine the insurer's obligation and liability under the policy contract. In this role, you will prepare reports on investigations, settlements, claim denials, and evaluations of involved parties. You will set reserves within authorized limits and recommend reserve changes to the Team Leader. Regularly reviewing the progress and status of claims with the Team Leader will be part of your responsibilities, along with discussing any issues or suggested improvements. Identifying and reporting any potential risks or undesirable exposures to the Team Leader is essential. You will assist in developing efficient methods and improvements for claims handling, promptly and fairly settling claims, and obtaining necessary releases, proofs of loss, compensation agreements, and issuing company drafts for claim payments. Communication is key, as you will need to convey claim denials to claimants, insured individuals/customers, or attorneys when applicable. Additionally, you will support the Team Leader and company attorneys in preparing cases for trial, including arranging witness attendance and taking statements, while making efforts to settle claims before trial. Participation in claim file reviews and audits with the customer/insured and broker will also be required. Timely and accurately administering claim benefits and maintaining control of the claim resolution process to minimize current exposure and future risks are critical aspects of this position. A solid understanding of the insurance industry, basic knowledge of claims handling concepts, practices, and procedures, and proficiency in Microsoft Word, Excel, and Outlook are necessary for success in this role. An analytical and detail-oriented mindset, strong customer focus, and excellent communication skills are essential attributes for a Claims Trainee.
Responsibilities
- Review claims and policy information to gather necessary background for investigation.
- Conduct interviews and obtain statements from insured individuals, claimants, witnesses, medical professionals, attorneys, and police officers.
- Evaluate information collected during investigation to determine the insurer's obligation and liability under the policy contract.
- Prepare reports on investigations, settlements, claim denials, and evaluations of involved parties.
- Set reserves within authorized limits and recommend reserve changes to the Team Leader.
- Regularly review the progress and status of claims with the Team Leader and discuss any issues or suggested improvements.
- Identify and report any potential risks or undesirable exposures to the Team Leader.
- Assist in the development of efficient methods and improvements for claims handling.
- Promptly and fairly settle claims and obtain necessary releases, proofs of loss, compensation agreements, and issue company drafts for claim payments.
- Communicate claim denials to claimants, insured individuals/customers, or attorneys when applicable.
- Support the Team Leader and company attorneys in preparing cases for trial, including arranging witness attendance and taking statements.
- Make efforts to settle claims before trial.
- Participate in claim file reviews and audits with the customer/insured and broker.
- Timely and accurately administer claim benefits.
- Maintain control of the claim resolution process to minimize current exposure and future risks.
Requirements
- Bachelor's or Master's degree or equivalent experience.
- An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters.
- Proficiency in Microsoft Word, Excel, and Outlook.
- Analytical and detail-oriented mindset.
- Strong customer focus with the ability to respond promptly and appropriately.
- Excellent communication skills, including active listening and collaboration.
Nice-to-haves
- Experience in the insurance industry.
- Basic knowledge of claims handling concepts, practices, and procedures.
Benefits
- Comprehensive benefits package including health insurance, dental insurance, and vision insurance.
- Discretionary annual incentive program.
