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Sr. Workers Compensation Specialist

127690

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. While the model provides a high level of flexibility and autonomy, occasional circumstances requiring in-office attendance should be expected. This position will follow a hybrid work schedule based out of the Woodland Hills, CA office or be fully remote for candidates who reside in and maintain a permanent residence within the state of California.

The ideal candidate will have experience in handling Workers Compensation claims of high exposure and complexity in California jurisdictions, all of which require state licenses in good standing. The job requirement also includes working within a specific authority level, must have knowledge and understanding of Medicare Compliance, as well as empathy towards severely injured workers and the employers.

In this role you will be responsible for:

+ Document claim files by accurately capturing and updating claims data/information in compliance with Best Practices for Workers Compensation claims of high exposure and complexity.

+ Exercise judgment to determine compensability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.

+ Confirm policy verification and coverage by analyzing applicable material and determining whether the loss falls within the coverage.

+ Work to have a timely resolution to claims by developing case strategy and case evaluation, and 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 exposure or range of exposure allowed by law.

+ Negotiate settlement of claim by establishing appropriate strategy and utilizing available tools and resources within authority limits.

+ Meet quality standards by following 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 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:

+ Highly Preferred experience in managing WC claims in jurisdictions of California and Arizona

+ Self Insured license

+ Highly Preferred deep experience in handling catastrophic Workers Compensation in complexity and high exposure claims

+ Working with Customers

+ Customer Service skills

+ 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 clickhere (https://www.zurichna.com/careers/benefits) . 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 compensation 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.

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 clickhere (https://www.zurichna.com/careers) to learn more.

Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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 - Woodland Hills, AM - California Virtual Office

Remote Working: Hybrid

Schedule: Full Time

Employment Sponsorship Offered: No

Linkedin Recruiter Tag: #LI-MD1 #LI-ASSOCIATE #LI-REMOTE

EOE Disability / Veterans