Sr. Claims Specialist, Workers Compensation (NE Region)

Zurich Insurance Group•Boston, NH

1d•Hybrid

About The Position

Zurich North America is seeking an accomplished Workers’ Compensation Senior Claims Specialist to join our Northeast Region team. This opportunity offers a hybrid work schedule from our Parsippany, NJ or Boston, MA offices, or the flexibility to work fully remotely from one of the following states dependent on location: Maine, Vermont, New Hampshire, Massachusetts, Connecticut, Rhode Island, New York, Pennsylvania, New Jersey, Virginia, Washington, D.C., or Delaware. 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.

Requirements

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

Nice To Haves

6+ years of experience in the Workers Compensation line of business
6+ years of experience handling litigation management
Specializing in some combination of the following jurisdictions of NJ, NY, PA, VA, DC or DE
Learn and handle additional jurisdictions as needed
EDI filing requirements
MSA/Medicare knowledge
WCCA, WCCP Designations
Knowledge and skill of claims handling
Negotiation experience
Experience in line of business
Excellent communication skills
Analytical skills

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.