Workers Compensation Claims Specialist I or II

Workers Compensation Claims Specialist I or II Zürich is seeking an experienced Workman’s Compensation Claims Specialist I or II to join our team. Candidates must be able to work from the Northeast with jurisdictions of CT, MA, and ME. Responsibilities Document claims file by accurately capturing and updating claims data/information in compliance with best practices. 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 and confirming loss falls within coverage. Develop case strategy, evaluate cases, and resolve claims in a timely manner, escalating issues as appropriate. Establish timely reserves and perform ongoing review throughout the claims cycle within authority limits. Assess damages and calculate applicable damages or ranges allowed by law. Negotiate settlement of claim by establishing appropriate negotiation strategy and using available tools within authority limits. Meet quality standards by following best practices. Ensure customer service by proactively communicating information and responding to inquiries. Manage expenses within vendor‑approved networks and outside contractors, with manager approval for non‑approved vendors. Ensure legal compliance with state and federal laws, regulations and internal controls. Refer claim to subrogation and fraud teams when potential subrogation and fraud is identified. Contribute to profitable growth by providing risk insight, information and trends to the Business Unit or customer. Protect Zürich’s reputation by maintaining confidentiality of claims information. Maintain professional and technical knowledge by participating in educational opportunities and professional societies. Qualifications Basic Qualifications: Bachelor’s degree and at least 2 years of experience in the Claims or Insurance area, or equivalent. Zurich Certified Insurance Apprentice including an associate degree and 2+ years of experience in the Claims or Insurance area, or High School Diploma or equivalent and 4+ years of experience, or Completion of Zurich Claims Training Program and 1+ year of experience. Must obtain and maintain required adjuster license(s). Knowledge of insurance regulations, markets and products. 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 multi‑tasking skills. Experience collaborating in a team environment and building cross‑functional working relationships. Ability to identify and explain complex financial and/or actuarial concepts. Understanding of the reserving process for indemnity and expense in moderately complex claims. Ability to develop and execute a negotiation strategy and plan for resolution. Ability to identify subtleties in customer/client interactions and present information necessary for claim resolution. Compensation Combined salary range for this position is $49,500.00 – $98,200.00. The proposed salary range for a Specialist I is $49,500.00 – $81,000.00, and for a Specialist II $59,900.00 – $98,200.00. Short‑term incentive bonus eligibility is set at 10%. Location and Schedule Locations: Parsippany, Boston, Connecticut Virtual Office, Delaware Virtual Office, Maine Virtual Office, Maryland Virtual Office, Massachusetts Virt. Office, New Hampshire Virt. Office, New Jersey Virtual Office, New York Virtual Office, Pennsylvania Virtual Office, Rhode Island Virtual Office, Vermont Virtual Office, Virginia Virtual Office, Washington DC, West Virginia Virt. Office. Remote working: Hybrid. Schedule: Full Time. EEO Statement 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. #J-18808-Ljbffr Zurich 56 Company Ltd