Senior Workers Compensation Claims Specialist

19 hours ago

Woodland Hills, California, United States Zurich Insurance Company Ltd. Full time
Job Title: Senior Workers Compensation Claims Specialist

Zurich North America is seeking an experienced Senior Workers Compensation Claims Specialist to join our team. As a key member of our claims team, you will be responsible for handling complex workers compensation claims with moderate to high exposure and complexity.

Key Responsibilities:
  • Document claims files by accurately capturing and updating claims data/information in compliance with best practices.
  • Exercise judgment to determine liability by gathering and analyzing relevant facts, utilizing applicable law, and 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, and escalating issues as appropriate.
  • Establish timely reserves and perform ongoing review throughout the claims cycle within authority limits by estimating and validating the value of claims.
  • Assess damages by calculating applicable damages or range of damages allowed by law.
  • Negotiate settlement of claims by establishing an appropriate negotiation strategy and utilizing available tools and resources within authority limits.
  • Meet quality standards by following best practices.
Requirements:
  • Bachelor's Degree and 6 or more years of experience in the Claims and/or Litigation Management area.
  • Juris Doctor and 2 or more years of experience in the Claims and/or Litigation Management area.
  • Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/or Litigation Management area.
  • Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/or Litigation Management area.
  • High School Diploma Equivalent and 8 or more years of experience in the Claims and/or Litigation Management area.
  • Must obtain and maintain required adjuster license(s).
  • Microsoft Office experience.
  • Knowledge of insurance regulations, markets, and products.
Preferred Qualifications:
  • 5 or more years of experience handling Workers Compensation claims with high severity and exposure.
  • Currently holds an active adjusters license in the state of California.
  • 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 complex claims.
  • Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims.
  • Ability to determine the scope and exposure for complex claims.
  • Ability to leverage trend and relationships to provide high-quality customer service.
  • Well-versed in identifying, understanding, and explaining complex financial and/or actuarial trends/concepts.
  • Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims.
  • Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies.

Zurich offers a comprehensive employee benefits package and competitive compensation. Please click here to learn more.

Zurich is an equal opportunity employer and welcomes applications from diverse candidates. We do not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status, or any other legally protected status.

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