ESIS Medical Claims Analyst

ESIS, Inc. (ESIS) provides sophisticated risk management services designed to reduce claims frequency and loss costs. ESIS, the Risk Management Services Company of ACE USA, provides claims, risk control & loss information systems to Fortune 1000 accounts. ESIS employs more than 1,500 professionals in nine regional centers and 15 major claims offices, as well as local representatives in select jurisdictions. We take our fiduciary responsibilities seriously and are proud to manage over $2.5 billion of customer losses and over 320,000 new claims annually. We specialize in large accounts which have multi-state operations. For information regarding ESIS please visit www.esis.com.

Summary:

ESIS is seeking an experienced workers' compensation Medical Claims Analyst for the Southfield MI. The person in this role will handle and maintain Medical Only Workers’ Compensation claims and file reviews under the general supervision of a supervisor and as part of the ESIS team.

Minimum Responsibilities:

• Receive new claim losses and verify accuracy of information submitted.             
• Provide customer service to agents, insureds, clients and other customers.
• Process medical only claims that are clearly work related and do not require investigation.
• Process authorized payments.
• Input data entry correspondence into claim system, and review files at appropriate intervals determined by Best Practices.
• Complete required state forms.
• Typing, photocopying, indexing and filing.
• Maintain desk according to Best Practice Standards

• 1-2 years previous claims processing experience.
• Strong customer service background.
• Ability to operate and contribute positively in a team-based environment.
• Good written and oral communication skills including effective telephone skills.
• Ability to work independently under limited supervision.
• Superior organizational skills and the ability to effectively manage multiple priorities.
• Demonstrate initiative as evidenced by the ability to self-manage, organize and prioritize work.
• Strong working knowledge of computer systems and various Microsoft applications such as Word, Excel and Outlook
• Committed to high standards of behavior and performance.
• An applicable resident or designated home state adjuster’s license is required for ESIS Field Claims Adjusters.  Adjusters that do not fulfill the license requirements will not meet ESIS’s employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.