Sr. Claims Specialist, Workers Compensation (Maine)

Zurich is looking for an accomplished Workers Compensation Sr. Claims Specialist for or our Northeast region. This position offers a hybrid work schedule from our Parsippany or Boston offices, or a fully remote setup based in one of the following states: Connecticut, Delaware, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, or Vermont.

 

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:

 

• 6+ years of experience in the Workers Compensation line of business
• 6+ years of experience handling litigation management
• Specializing in the jurisdiction of Maine lost time & litigated claims
• EDI filing requirements
• MSA/Medicare knowledge
• MA, CT jurisdictional knowledge & license required
• expertise in managing all jurisdiction within the New England states
• WCCA, WCCP Designations
• Knowledge and skill of claims handling
• Negotiation experience
• Experience in line of business
• Excellent communication skills
• Analytical skills

 

 

At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. For more information about our Total Rewards, please click here. Additional rewards may encompass short-term incentive bonuses and merit increases. We encourage candidates with salary expectations beyond the provided range to apply as they will be considered based on their experience, skills, and education. 

The compensation indicated represents a nationwide market range and has not been adjusted for geographic differentials pertaining to the location where the position may be filled. The proposed salary range for this position is $7