Workers Compensation Claims Specialist II

Zurich is seeking an experienced Workman’s Compensation Claims Specialist to join our team. The role is based in the Northeast and covers jurisdictions in Connecticut, Massachusetts, and Maine. In this role you will be responsible for: Documenting claims files by accurately capturing and updating claims data in compliance with best practices for moderate exposure and complexity claims. Using judgement to determine liability by gathering and analyzing relevant facts, applying applicable law, and establishing principles of negligence. Assessing policy verification and coverage determinations and deciding whether the loss falls within coverage. Developing case strategy and evaluation, escalating issues as appropriate to achieve timely resolution. Establishing reserves and performing ongoing review during the claims cycle within authority limits. Calculating applicable damages or ranges of damages allowed by law. Negotiating settlement with appropriate strategy and tools within authority limits. Meeting quality standards by following best practices. Ensuring customer service through proactive communication and response to inquiries. Managing expenses within vendor‑approved networks and scopes of work for outside contractors, with manager approval when necessary. Maintaining legal compliance with state and federal laws, regulations, and internal control requirements. Referencing claims to subrogation and fraud teams when applicable. Contributing to profitable growth by providing risk insight, information, and trends to the business unit or client. Protecting Zurich’s reputation by keeping claims information confidential. Maintaining professional and technical knowledge through education, industry trends, personal networks, and professional societies. Basic Qualifications Bachelor’s Degree and 3 or more years of experience in the claims or insurance area. Zurich Certified Insurance Apprentice, including an associate degree and 3 or more years of experience. Completion of Zurich Claims Training Program and 2 or more years of experience. High School Diploma or Equivalent and 5 or more years of experience. 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, 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 multitasking skills. Experience collaborating in a team environment and building cross‑functional relationships. Adept at identifying and explaining complex financial and/or actuarial concepts. Ability to determine the scope and exposure for moderately complex claims. Understanding of the reserving process for indemnity and expense in analyzing potential exposure. Ability to develop and execute negotiation strategies and resolution plans. Ability to identify subtleties in client and business partner interactions. Ability to present information necessary to propose a claim resolution to stakeholders. Pay range: $59,900.00 – $98,200.00, with a short‑term incentive bonus eligibility set at 10%. Compensation may vary by experience and location. Benefits: Zurich offers comprehensive benefits for employees and their families. Location: Northeast (CT, MA, ME). Equal Opportunity Employer: Zurich in North America does not discriminate based on race, ethnicity, color, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, veteran status, marital status, sexual orientation, pregnancy, or any other characteristic protected by applicable law. Equal Opportunity Employer – disability and veterans. #J-18808-Ljbffr Zurich North America