Zurich Insurance - Sacramento, CA
posted 23 days ago
Full-time - Mid Level
Remote - Sacramento, CA
Insurance Carriers and Related Activities
About the position
The Senior Workers Compensation Claims Specialist at Zurich is responsible for managing single and multi-party commercial line Workman's Compensation claims of moderate to high exposure and complexity. This role focuses on ensuring efficient claims handling while delivering a customer-centric service. The position requires exercising judgment in liability determination, policy verification, and coverage determination, as well as negotiating settlements and maintaining quality standards throughout the claims process.
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; establishing basic principles of negligence.
- Determine policy verification and coverage determination by analyzing applicable coverage for claims.
- Develop case strategy and evaluation for timely resolution of claims; escalate issues as appropriate.
- Establish timely reserves and perform ongoing review throughout claims cycle within authority limit.
- Assess damages by calculating applicable damages or range of damages allowed by law.
- Negotiate settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources.
- Meet quality standards by following best practices.
Requirements
- Bachelor's Degree and 6 or more years of experience in the Claims and/or Litigation Management area.
- Juris Doctor and 2 or more years of experience in the Claims and/or Litigation Management area.
- Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/or Litigation Management area.
- Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/or Litigation Management area.
- High School Diploma Equivalent and 8 or more years of experience in the Claims and/or Litigation Management area.
- Must obtain and maintain required adjuster license(s).
- Microsoft Office experience.
- Knowledge of insurance regulations, markets and products.
Nice-to-haves
- Currently holds an active adjusters license in the state of Arizona and/or California.
- 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.
- Ability to gather unique perspectives from other teams/functions to optimize outcomes.
- 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.
Benefits
- Competitive compensation package
- Short term incentive bonuses
- Merit increases
- Comprehensive employee benefits package for employees and eligible dependents
