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Sr. Claim Specialist, Workman's Compensation

Virtual, PA, US

Zurich North America is seeking an experienced Senior Claims Specialist in Workers' Compensation to join our team.

 

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. This position can be either a hybrid position in our Parsippany, NJ or Boston, MA offices, or fully remote for candidates who do not live near our physical offices. We are seeking applicants with experience in handling Workers’ Compensation claims for PA, VA, DC, and DE.

 

The Senior Workers' Compensation Claims Specialist will manage workers’ compensation claims of moderate to high exposure and complexity, within defined authority limits. This role focuses on ensuring claims are handled efficiently and effectively, with an emphasis on delivering exceptional, customer-centric service.

 

In this role, you will be responsible for:

 

  • Documenting claims files by accurately capturing and updating claims data and information, ensuring compliance with best practices for commercial claims of moderate to high exposure and complexity.
  • Exercising sound judgment to determine liability by gathering and analyzing relevant facts, applying applicable law, and establishing basic principles of negligence.
  • Conducting policy verification and making coverage determinations by analyzing applicable coverage for claims and assessing if the loss falls within the policy’s terms.
  • Driving timely claims resolutions by developing case strategies, performing case evaluations, and escalating issues as appropriate.
  • Setting and reviewing reserves promptly throughout the claims cycle within authority limits, including estimating and validating claim values.
  • Assessing damages by calculating applicable damages or the range permitted by law.
  • Negotiating claim settlements by establishing an effective negotiation strategy and using available tools and resources within authority limits.
  • Meeting quality standards by adhering to established best practices.

 

Basic Qualifications:

 

  • Bachelor’s Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.
    OR
  • Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.
    OR
  • Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience …
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