Sr. Claims Specialist, Workers Compensation

Zurich North America is seeking an experienced Senior Claims Specialist in Workers' Compensation to join our team. While we prefer candidates who can work out of our Woodland Hills, CA office, we are open to considering remote applicants located in California, provided they hold a current California state license.

 

The Senior Workers Compensation Claims Specialist will handle multi-party commercial line Workman’s 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.

 

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 single and multi-party personal or commercial line claims of moderate to high 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:

 

• 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 6 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:

 

• 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<