Workers Compensation, Litigated, Claims Specialist II

Zurich North America is seeking a sharp, solutions-driven Workers’ Compensation Litigated Claims Specialist II to join our high-performing team. This is an opportunity to make meaningful impact at a company known for innovation and excellence in the insurance industry. We are hiring in three dynamic locations: Schaumburg, IL (hybrid schedule), Indianapolis, IN (fully remote) or Ohio (fully remote).

 

We are seeking a candidate with proven expertise in managing litigated workers’ compensation claims in the following jurisdictions: Indiana, Illinois, Michigan and/or Ohio. This multi-state experience is essential to effectively support our regional claims operations and drive strong outcomes.

 

In this position you will manage Worker’s Compensation multi-party commercial line 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 worker’s 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.
• 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 degree and 3 or more years of experience in the Claims or Insurance area
  OR
• Zurich Certified Insurance Apprentice, including an associate degree with 3 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
  OR
• High School Diploma Equivalent and 5 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: 

 

• 5+ years of experience handling Litigated Workers Compensation claims
• Professional experience working for an insurance carrier(s)
• Experience handling commercial claims
• Highly preferred Jurisdictions in the following states: IL, IN, MI and OH
• Spanish/English bilingual candidates preferred
• Exceptional verbal and written communication skills, with the ability to clearly convey complex coverage determinations to clients, customers, and brokers.
• Analytical thinker with strong problem-solving, critical thinking, and financial acumen; skilled in interpreting insurance policies, evaluating exposure, and identifying actuarial trends.
• Adept at multi-tasking and prioritization in fast-paced environments, with a proactive approach to sharing insights and optimizing outcomes across functions.
• Proven ability to collaborate across teams, build cross-functional relationships, and leverage diverse perspectives to improve claim outcomes.
• Experienced in guiding complex litigated claims, including directing counsel, managing litigation strategy, and following best practices for reserving indemnity, medical, and expense components.

 

 

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 law