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About the Role
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.
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.
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 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
Skills
- 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
Location
- Parsippany, NJ
- Boston, MA
- Maine
- Vermont
- New Hampshire
- Massachusetts
- Connecticut
- Rhode Island
- New York
- Pennsylvania
- New Jersey
- Virginia
- Washington, D.C.
- Delaware
Work Type
- Hybrid
- Remote
Experience Level
- Senior
Education Level
- Bachelor's Degree
- Juris Doctor
- Associate Degree
- High School Diploma Equivalent
Salary/Compensations
- $75,800-124,100.00
- short-term incentive bonus eligibility set at 15%
Benefits
- Competitive pay
- Comprehensive benefits for employees and their families
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®.
Equal Opportunity
- Zurich in 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.