Zurich Insurance · 4 hours ago
Workers' Compensation Claims Specialist II
United States
Full-time
Remote
Mid Level
$60K/yr - $98K/yr
3+ years expZurich Insurance is seeking an experienced Workers' Compensation Claims Specialist to join their team. The role involves handling commercial line Workers' Compensation claims of moderate to high exposure, ensuring efficient and customer-centric claims service while adhering to legal compliance and best practices.
Financial ServicesInsuranceProductivity Tools
No H1B
Responsibilities
Document claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity personal or commercial line claims
Exercise judgement 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
Ensure customer service by proactively communicating information; responding to inquiries; following customer protocols and may participating in customer marketing efforts
Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Departs from approved vendors with manager approval, where in the best interests of the insured
Ensure legal compliance by following state and federal laws and regulations and internal control requirements
Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud
Contribute to profitable growth by providing risk insight, information and trends to Business Unit or customer as needed
Protect Zurichs reputation by keeping claims information confidential
Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks. And participating in professional societies
Qualification
Required
Bachelor's Degree and 3 or more years of experience in the Claims or Insurance area OR
Zurich Certified Insurance Apprentice, including an Associate Degree and 3 or more years of experience in 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 or Equivalent and 5 or more years of experience in the Claims or Insurance area AND
Must obtain and maintain required adjuster license(s)
Knowledge of insurance regulations, markets and products
Microsoft Office experience
Preferred
Jurisdiction knowledge of Virginia, West Virginia, Pennsylvania, or New Jersey, Delaware or Washington DC
Effective verbal and written communication skills
Strong analytical, critical thinking, and problem solving skills
Solid time management, prioritization and multi-tasking skills
Experience collaborating in a team environment and building cross functional working relationships
Adept in identifying and explaining complex financial and/or actuarial concepts
Ability to determine the scope and exposure for moderately complex claims
Demonstrates understanding of the reserving process for indemnity and expense in analyzing the potential exposure of moderately complex claims
Ability to develop and execute a negotiation strategy and plan for resolution
Ability to identify subtleties in customer/client and/or business partner interactions
Ability to present information necessary to propose a claim resolution to stakeholders
Benefits
Short-term incentive bonus eligibility set at 10%
Competitive pay and comprehensive benefits for employees and their families
Company
Zurich Insurance
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.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
unknown2020-12-07IPO
Leadership Team
Aleksandar Vidovic
CEO
Walter Jopp
Chief Executive Officer - ME Life
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