ESIS Claims Representative, WC
On-siteGlen Allen, Virginia, United States
Job Summary
Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies. Act as the primary point of contact for injured workers, employers, medical providers, and stakeholders, delivering clear communication throughout the process. Conduct thorough investigations by gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability. Make timely decisions regarding claim acceptance, denial, or settlement based on case facts. Maintain detailed claim files within the management system and monitor costs including medical expenses and indemnity payments. Ensure adherence to state-specific workers' compensation laws and collaborate with internal legal, medical, and risk management teams. This role is located in the Glen Allen, VA office and requires a manager's general supervision.
Required Qualifications
- Experience in workers' compensation claims support
- Knowledge of applicable laws, regulations, and company policies regarding workers' compensation
- Ability to communicate clearly and professionally with injured workers, employers, medical providers, and other stakeholders
- Ability to conduct thorough investigations including gathering statements, reviewing medical records, and analyzing accident reports
- Ability to make timely and accurate decisions regarding claim acceptance, denial, or settlement
- Ability to maintain detailed and organized claim files
- Knowledge of state-specific workers' compensation laws, regulations, and reporting requirements
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.