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About the Role
Handle single and multi-party commercial line Workman’s Compensation claims of moderate to high exposure and complexity within specific authority limits, ensuring efficient and effective claims handling with a customer-centric approach.
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 judgment to determine liability by gathering and analyzing relevant facts, utilizing applicable law, and establishing basic principles of negligence.
- Determine policy verification and coverage by analyzing applicable coverage for claims and whether the loss falls within the coverage.
- Work towards timely resolution of claims by developing case strategy, evaluating cases, and 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 potentially participating in customer marketing efforts.
- Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors, departing 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 Zurich’s 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.
Requirements
- Must obtain and maintain required adjuster license(s)
- Microsoft Office experience
- Knowledge of insurance regulations, markets and products
- 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
Skills
- Claims handling
- Insurance
- Liability determination
- Policy verification
- Coverage determination
- Case strategy development
- Reserving
- Damage assessment
- Negotiation
- Customer service
- Expense management
- Legal compliance
- Subrogation
- Fraud identification
- Risk insight
- Confidentiality
- Professional development
- Industry trend analysis
- Networking
- Microsoft Office
- Insurance regulations
- Insurance markets
- Insurance products
- Verbal communication
- Written communication
- Analytical skills
- Critical thinking
- Problem-solving skills
- Time management
- Prioritization
- Multi-tasking
- Collaboration
- Cross-functional relationship building
- Financial concepts
- Actuarial concepts
- Reserving process
Location
- Parsippany
- Boston
- New Jersey Virtual Office
- New York Virtual Office
- Pennsylvania Virtual Office
- Connecticut Virtual Office
- Maryland Virtual Office
- Massachusetts Virt. Office
- Delaware Virtual Office
- Virginia Virtual Office
- New Hampshire Virt. Office
- Washington DC
- Maine Virtual Office
- Rhode Island Virtual Office
- West Virginia Virt. Office
- Vermont Virtual Office
Work Type
- Hybrid
- Full Time
Experience Level
- Claims Specialist I
- Claims Specialist II
Education Level
- Bachelor's degree
- Zurich Certified Insurance Apprentice
- Associate degree
- High School Diploma or Equivalent
- Completion of Zurich Claims Training Program
Salary/Compensations
- $49,500.00 - $98,200.00
- $49,500.00 - $81,000.00
- $59,900.00 - $98,200.00
Benefits
- Competitive pay
- Comprehensive benefits for employees and their families
- Short-term incentive bonus eligibility (10%)
About the Company
- Zurich North America is a leader in risk management, with over 150 years of expertise and coverage across 25+ industries, including 90% of the Fortune 500®.
- At Zurich, we value your ideas and experience.
- We offer growth, inclusion, and a supportive environment—so you can help shape the future of insurance.
Equal Opportunity
- Zurich North America does not discriminate based on race, ethnicity, color, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law.
- Equal Opportunity Employer disability/vets.
- Zurich complies with 18 U.S. Code § 1033.