Sr. Claims Specialist, Workmans Compensation

Zurich Insurance - Maitland, FL

Full-time - Mid Level

Remote - Maitland, FL

Insurance Carriers and Related Activities

About the position

The Senior Workers' Compensation Claims Specialist at Zurich North America is responsible for managing complex, multi-party commercial Workers' Compensation claims with moderate to high exposure. This role emphasizes efficient claims handling and outstanding customer service, contributing to Zurich's reputation for excellence. The position is based in Maitland, FL, and offers a hybrid work schedule.

Responsibilities

• Document claims file by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal or commercial line claims of moderate to high exposure and complexity.
• Exercise judgment to determine liability 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.
• 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 within authority limits.
• Meet quality standards by following best practices.

Requirements

• Bachelor's degree and 6+ years of experience in Claims and/or Litigation Management.
• Juris Doctor with 2+ years of Claims and/or Litigation Management experience.
• Zurich Certified Insurance Apprentice, including an Associate Degree with 6+ years of Claims and/or Litigation Management experience.
• Completion of Zurich's Claims Training Program with 6+ years of experience in Claims and/or Litigation Management.
• High School Diploma or equivalent with 8+ years of experience in Claims and/or Litigation Management.
• Must obtain and maintain required adjuster licenses.
• Proficiency in Microsoft Office.
• Knowledge of insurance regulations, markets, and products.

Nice-to-haves

• 6+ years of experience handling high-severity Workers' Compensation claims.
• 6+ years of experience in litigation management.
• Experience handling claims in Florida.
• Effective verbal and written communication skills.
• Strong analytical, critical thinking, and problem-solving abilities.
• Ability to multi-task and prioritize effectively.
• Experience collaborating in a team environment and building cross-functional relationships.
• Proactive in sharing insights and gathering diverse perspectives to optimize outcomes.
• Strong understanding of insurance policies and ability to apply this knowledge to complex claims.
• Expertise in managing complex litigation and settlement strategies.
• Ability to provide high-quality customer service through trend analysis and relationship management.
• Skilled in explaining complex financial and actuarial trends.

Benefits

• Comprehensive employee benefits package for employees and eligible dependents.
• Ongoing career development opportunities.
• Hybrid work schedule.