Claims Specialist II - Workers Compensation

Claims Specialist II - Workers Compensation 132811 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. While the model provides a high level of flexibility and autonomy, occasional circumstances requiring in‑office attendance should be expected. Zurich North America is hiring an Claims Specialist II to join our Workers Compensation team! We are open to hiring talent in one of the following locations: Schaumburg or Overland Park. Purpose With moderate direction, handles workers compensation claims of low to moderate exposure and complexity within specific limits of authority by following established protocols to ensure that claims are handled in the most efficient, effective way while delivering a customer‑centric claims service. Key Accountabilities 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. Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks. And participating in professional societies. Business Travel, as required Extended Hours during Peak Periods, as required Pass Applicable Exam/Licensing, as required Basic Qualifications 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 Preferred Qualifications 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 Your pay at Zurich is based on your role, location, skills, and experience. We follow local laws to ensure fair compensation. You may also be eligible for bonuses and merit increases. If your expectations are above the listed range, we still encourage you to apply—your unique background matters to us. The pay range shown is a national average and may vary by location. The proposed Salary range for this position is $59,900.00 - $98,200.00, with short-term incentive bonus eligibility set at 10%. We offer competitive pay and comprehensive benefits for employees and their families. Learn more about Total Rewards here. 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. 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®. Join us for a brighter future—for yourself and our customers. 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. Location & Employment Location(s): AM - Schaumburg, AM - Overland Park. Remote Working: Hybrid. Schedule: Full Time. Employment Sponsorship Offered: No. Linkedin Recruiter Tag: #LI-JM1 #LI-ASSOCIATE #LI-HYBRID #J-18808-Ljbffr Zurich 56 Company Ltd