Workers Compensation Claims Specialist II

Workers Compensation Claims Specialist II 133801 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 CT, MA and ME. The Workers Compensation Claims Specialist will handle single and 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. In this role you will be responsible for: 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 judgement 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. 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. Basic Qualifications: Bachelor’s Degree and 3 or more years of experience in the Claims or Insurance areaOR Zurich Certified Insurance Apprentice, including an associate degree and 3 or more years of experience in Claims or Insurance areaOR Completion of Zurich Claims Training Program and 2 or more years of experience in the Claims or Insurance areaOR High School Diploma or Equivalent and 5 or more years of experience in the Claims or Insurance areaAND Must obtain and maintain required adjuster license(s) Knowledge of insurance regulations, markets and products Microsoft Office experience Preferred Qualifications: 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 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. 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. Employment Sponsorship Offered: No Location(s): AM - Parsippany, AM - Boston, AM - Connecticut Virtual Office, AM - Delaware Virtual Office, AM - Maine Virtual Office, AM - Maryland Virtual Office, AM - Massachusetts Virt. Office, AM - New Hampshire Virt. Office, AM - New Jersey Virtual Office, AM - New York Virtual Office, AM - Pennsylvania Virtual Office, AM - Rhode Island Virtual Office, AM - Vermont Virtual Office, AM - Virginia Virtual Office, AM - Washington DC, AM - West Virginia Virt. Office Remote Working: Hybrid Schedule: Full Time EOE Disability / Veterans #J-18808-Ljbffr Zurich NA