Sr. Claims Specialist , Workers Compensation

Zurich is currently looking for a Senior Workers Compensation Claims Professional with New York claims experience to join the Workers’ Compensation Claims organization.

 

This is either a virtual position or hybrid position for those who live near one of our regional offices.  This will allow balance for working remotely and in the office when needed. Office locations: New York, Parsippany, NJ or Boston, MA.   

 

Our teams are dedicated to helping our customers manage claims with moderate to high complexity exposures and losses. At this level, you will work with a high level of autonomy and decision-making to manage your claims caseload while providing technical claims service excellence, policy interpretation and coverage analysis. 

 

Some of the daily responsibility: 

 

• 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; 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.
• 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

 

Required 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:

 

• 6+ years of experience handling high severity Worker Compensation claims
• 6+ years of litigation management experience
• Jurisdictional expertise and experience working in the states of NY
• 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