FreshRemote.Work

Sr. Claims Specialist , Workman's Compensation

Virtual, NY, US

Zurich is currently looking for a Senior Workers Compensation Claims Professional with New York claims experience to join the Workers’ Compensation Claims organization.

 

This is either a virtual position or hybrid position for those who live near one of our regional offices.  This will allow balance for working remotely and in the office when needed. Office locations: New York, Parsippany, NJ or Boston, MA.   

 

Our teams are dedicated to helping our customers manage claims with moderate to high complexity exposures and losses. At this level, you will work with a high level of autonomy and decision-making to manage your claims caseload while providing technical claims service excellence, policy interpretation and coverage analysis. 

 

Some of the daily responsibility: 

 

  • Document claims file by accurately capturing and updating claims data/information in compliance with best practices for workers’ compensation claims of moderate to high exposure and complexity.
  • Exercise judgment to determine compensability 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.
  • 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

 

Required 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 in the Claims and/ or Litigation Management area.
    OR
  • Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.
    OR
  • High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.
    AND
  • Must obtain and maintain required adjuster license(s)
  • Microsoft Office experience
  • Knowledge of insurance regulations, markets and products

 

Preferred Qualifications:

 

  • 6+ years of experience handling high severity Worker Compensation claims
  • 6+ years of litigation management experience
  • Jurisdictional expertise and experience working in the states of NY
  • Effective verbal and written communication skills
  • Strong analytical, critical thinking and problem-solving skills
  • Strong multi-tasking and prioritization skills
  • Experience collaborating in a team environment and building cross functional working relationships
  • Proactively shares and promotes sharing of insights
  • Ability to gather unique perspectives from other teams/functions to optimize outcomes.
  • Understands, analyzes, and applies the component parts of an insurance policy for complex claims
  • Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims
  • Ability to determine the scope and exposure for complex claims
  • Ability to leverage trend and relationships to provide high-quality customer service
  • Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts.
  • Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims
  • Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies

 

At Zurich, compensation for roles is influenced by a variety of factors, including but not limited to the specific office location, role, skill set, and level of experience. In compliance with local laws, Zurich commits to providing a fair and reasonable compensation range for each role. For more information about our Total Rewards, please click here. Additional rewards may encompass short-term incentive bonuses and merit increases. We encourage candidates with salary expectations beyond the provided range to apply, as they will be considered based on their experience, skills, and education. The salary indicated represents a nationwide market range and has not been adjusted for geographic differentials pertaining to the location where the position may be filled. The proposed salary range for this position is $74,300.00 - $121,700.00, with short-term incentive bonus eligibility set at 15%.

 

 

As an insurance company, Zurich is subject to 18 U.S. Code § 1033. 
 

As a condition of employment at Zurich, employees must adhere to any COVID-related health and safety protocols in place at that time (https://www.zurichna.com/careers/faq).

 

A future with Zurich. What can go right when you apply at Zurich?

 

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please click here to learn more.

 

As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet 

 

Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission. 

 

Location(s): AM - New York Virtual Office
Remote Working: Hybrid
Schedule: Full Time
Employment Sponsorship Offered: No 
 
Linkedin Recruiter Tag: #LI-MD1 #LI-ASSOCIATE #LI-HYBRID 

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Job Profile

Regions

North America

Countries

United States

Restrictions

Must live near regional offices for hybrid option Must obtain and maintain required adjuster licenses

Benefits/Perks

Career development Career development opportunities Competitive compensation Flexible work environment Hybrid work Hybrid work option Merit increases Ongoing career development Remote work option Team environment Total Rewards Training

Tasks
  • Analyze coverage
  • Determine compensability
  • Develop case strategy
  • Document claims
  • Document claims files
  • Establish reserves
  • Manage claims
  • Manage claims caseload
  • Meet quality standards
  • Negotiate settlements
  • Policy verification
  • Training
Skills

Analytical Casualty insurance Claims Claims management Communication Compliance Coverage Analysis Critical thinking Customer service Insurance Insurance Industry Insurance Regulations Litigation Litigation management Microsoft Office Multi-tasking Negotiation Organization Policy interpretation Prioritization Problem-solving Risk Management Safety Technology Training Workers Compensation Written communication

Experience

6 years

Education

Associate degree Bachelor's degree Diploma Equivalent High school diploma Juris Doctor Zurich Certified Insurance Apprentice Zurich claims training program

Certifications

Zurich Certified Insurance Apprentice Zurich Claims Training Program

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9