Workers Compensation Claims Specialist I

Zurich is seeking an experienced Workman’s Compensation Specialist to join our team! We are specifically seeking candidates who can work remotely from California.

The Workers Compensation Claims Specialist will handle multi-party commercial line Workman’s Compensation claims of low to moderate 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.

In this role you will be responsible for:

• Document claims file by accurately capturing and updating claims data/information in compliance with best practices multi-party commercial line claims of low to moderate exposure and complexity.


• Exercise judgment to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.


• Exercise judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.


• 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 by estimating and validating value of claims.


• Assess damages by calculating applicable damages or range of damages allowed by law.


• 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:

• Bachelors Degree and 2 or more years of experience in the Claims or Insurance area
  OR


• Zurich Certified Insurance Apprentice including an Associate Degree and 2 or more years of experience in the Claims or Insurance area
  OR


• High School Diploma or Equivalent and 4 or more years of experience in the Claims or Insurance area
  OR


• Completion of Zurich Claims Training Program and 2 or more years of experience in the Claims or Insurance area
  AND


• Must obtain and maintain required adjuster license(s)


• Microsoft Office experience


• Knowledge of insurance regulations, markets and products

Preferred Qualifications:

• Valid Self-Insured (SIL) License


• 3+ years of experience in Workers' Compensation claims handling


• Jurisdictional experience handling claims in CA


• Experience working for a major carrier


• Customer service experience


• Strong analytical, critical thinking and problem-solving skills


• Strong verbal and written communication skills


• Experience collaborating across work groups Ability to develop and maintain strong relationships


• Understands claims adjustment process and possesses ability to determine scope/exposure for losses


• Understands the use of vendors


• Understands and applies financial and actuarial/reserving concepts.


• Familiarity with negotiation strategies and experience in suggesting alternative approaches

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
Remote Working: Yes
Schedule: Full Time
Employment Sponsorship Offered: No 
 
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