Workers' Compensation Examiner, Medical Only
Location: New Haven
Posted on: June 6, 2021
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 Medical Only
Claim Examiner 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 and reside in either our New
Haven, Connecticut, Basking Ridge, New Jersey or Jersey City, New
- 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
- Conducts 3-part ongoing investigations, obtaining facts and
taking statements as necessary, with insured, claimant and medical
- Evaluates the facts gathered through the investigation to
determine compensability of the medical treatment.
- Informs insureds and claimants of claim denials when
- Prepares reports on investigation, settlements, denials of
claims and 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, telephonic
cases managers on medical management.
- Complies with customer service requests including Special
Claims Handling procedures and file status notes.
- Files workers' compensation forms and electronic data with
states to ensure compliance with statutory regulations.
- Refers appropriate claims to subrogation and secures necessary
information to ensure that recovery opportunities are
- Works with in-house Technical Assistants, Special
Consultants, Telephonic Case Managers as well as Team
Supervisors to exceed customer's expectations for exceptional
claims handling service.
Competencies & Technical Skills:
- Entry-level Medical Only Claim Examiner position.
- Knowledge of insurance, claims, and workers' compensation
statutes, regulations and compliance are a plus, but on-the-job
training will be provided to chosen applicant.
- Ability to incorporate data analytics and modeling into daily
activities to expedite fair and equitable resolution of claims and
- A personal commitment to superior performance that adds value
to our company and our customers.
- An ability to work effectively with a wide variety of
- An aptitude for evaluating, analyzing and interpreting
- Superior telephonic skills.
- Excellent organizational skills.
- The ability to multi-task with proven time management skills to
- An ability to work well in teams.
- Demonstrate critical thinking and decision-making ability.
- Excellent verbal and written communication skills.
Experience, Education & Requirements:
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.
Keywords: Chubb, New Haven , Workers' Compensation Examiner, Medical Only, Other , New Haven, Connecticut
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