Workers Compensation Claims Handler IV

Zurich is seeking an experienced Workman’s Compensation Claims Specialist to join our team! We are specifically seeking candidates who can work from the Northeast with jurisdictions of CA, NV, AZ, and or WA.

To handle Workers’ Compensation claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.  Jurisdictional knowledge in California Workers Compensation is required. 

In this role you will be responsible for:

• Document claims file by accurately capturing and updating claims data/information in compliance with best practices for workers compensation claims of moderate to high exposure and complexity.
• Exercise judgment to determine compensability by gathering and analyzing relevant facts and utilizing applicable laws and statute.
• Exercise judgment to evaluate coverage by analyzing policy documents for location and date of loss.
• Work to have a timely resolution to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.
• Establish timely reserves and perform ongoing review throughout claims cycle within authority limit for most probable exposure and claim outcome.
• Assess exposure or range of exposure based on the case facts, jurisdictional statute, and claims experience.
• Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.
• Meet quality standards by following best practices

Basic Qualifications:

• Bachelor’s Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• Completion of Zurich Claims Training Program and 5 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.
  AND
• Must obtain and maintain required adjuster license(s)
• Microsoft Office experience
• Knowledge of insurance regulations, markets and products

Preferred Qualifications:

• Effective verbal and written communication skills
• Strong analytical, critical thinking and problem-solving skills
• Strong multi-tasking and prioritization skills
• Experience collaborating in a team environment and building cross functional working relationships
• Proactively shares and promotes sharing of insights
• Ability to gather unique perspectives from other teams/functions to optimize outcomes.
• Understands, analyzes, and applies the component parts of an insurance policy for moderate to complex claims
• Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of moderate to complex claims
• Ability to determine the scope and exposure for moderate to complex claims
• Ability to leverage knowledge of industry trends and relationships to provide high-quality customer service.
• Ability to effectively communicate coverage determinations to customers/clients/brokers for moderate to complex claims
• Ability to direct counsel on an ongoing basis to guide the course of moderate to complex litigation and settlement strategies

We offer competitive pay and comprehensive benefits for employees and their families. [Learn more about Total Rewards here.]

Why Zurich?

At Zurich, we value your ideas and experience. We offer growth, inclusion, and a supportive environment—so you can help shape the future of insurance. Zurich North America is a leader in risk management, with over 150 years of expertise and coverage across 25+ industries, including 90% of the Fortune 500®.

Join us for a brighter future—for yourself and our customers.

Zurich in North America does not discriminate based on race, ethnicity, color, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law. Equal Opportunity Employer disability/vets.

Zurich complies with 18 U.S. Code § 1033.

Please note: Zurich does not accept unsolicited CVs from agencies. Preferred vendors should use our Recruiting Agency Portal.

Location(s): AM - California Virtual Office, AM - Arizona Virtual Office, AM - Nevada Virtual Office, AM - Washington St Virt. Office
Remote Working: Yes
Schedule: Full Time
Employment Sponsorship Offered: No 
 
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