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Zurich Insurance · 2 days ago

Sr. Claims Specialist (Work Comp)

Calabasas, CA

Full-time

Hybrid

Mid, Senior Level

$83K/yr - $137K/yr

6+ years exp

Zurich Insurance is seeking an experienced Workman’s Compensation Sr. Claims Specialist to join their team. The role involves managing complex Workman’s Compensation claims, ensuring efficient handling and delivering customer-centric service while adhering to best practices.

Financial ServicesInsuranceProductivity Tools

Comp. & Benefits

No H1B

Responsibilities

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

Qualification

Claims ManagementWorkers CompensationAdjuster LicenseMicrosoft OfficeInsurance RegulationsAnalytical SkillsMulti-taskingCommunication SkillsProblem-Solving SkillsTeam Collaboration

Required

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

6 or more years of experience handling high severity Workers Compensation litigated claims

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

Benefits

Competitive pay

Comprehensive benefits for employees and their families

Short-term incentive bonus eligibility set at 15%

Company

Zurich Insurance

Glassdoor4.2

Zurich Insurance Group (Zurich) is a leading global multi-line insurer founded more than 150 years ago, which has grown into a business serving more than 75 million customers in more than 200 countries and territories, while delivering industry-leading total shareholder returns.

Founded in 1872

Zürich, Zurich, CHE

10001+ employees