Workers Compensation Claims Handler IV

Zurich Insurance Company Ltd.•Virtual, NV

1d•$75,800 - $124,100•Remote

About The Position

Zurich is seeking an experienced Workman’s Compensation Claims Specialist to join our team! We are specifically seeking candidates who can work from the Northeast with jurisdictions of CA, NV, AZ, and or WA. To handle Workers’ 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. Jurisdictional knowledge in California Workers Compensation is required.

Requirements

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 5 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
Jurisdictional knowledge in California Workers Compensation is required.

Nice To Haves

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 moderate to complex claims
Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of moderate to complex claims
Ability to determine the scope and exposure for moderate to complex claims
Ability to leverage knowledge of industry trends and relationships to provide high-quality customer service.
Ability to effectively communicate coverage determinations to customers/clients/brokers for moderate to complex claims
Ability to direct counsel on an ongoing basis to guide the course of moderate to complex litigation and settlement strategies

Responsibilities

Document claims file by accurately capturing and updating claims data/information in compliance with best practices for workers compensation claims of moderate to high exposure and complexity.
Exercise judgment to determine compensability by gathering and analyzing relevant facts and utilizing applicable laws and statute.
Exercise judgment to evaluate coverage by analyzing policy documents for location and date of loss.
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 for most probable exposure and claim outcome.
Assess exposure or range of exposure based on the case facts, jurisdictional statute, and claims experience.
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.