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Claims Specialist II (Workers Compensation)

Claims Specialist II (Workers Compensation)

Zurich Insurance CompanyOakland, CA, US
1 day ago
Job type
  • Full-time
Job description

Claims Specialist II (Workers Compensation)

Zurich North America is seeking a skilled and experienced Claims Specialist II to join our dynamic Workers Compensation team. This is an exciting opportunity to make a meaningful impact by delivering exceptional claims service and applying your expertise within a respected, industry leading organization.

While we prefer candidates who can collaborate in person at our Woodland Hills, CA office on a hybrid work schedule, we're open to qualified candidates working fully remotely, based from the West Coast through the Midwest regions who have demonstrated expertise handling California jurisdiction.

If you're looking to grow your career with a company that values excellence, innovation, and flexibility, we'd love to hear from you. The Workers Compensation Claims Specialist will handle multi-party commercial line Workman's Compensation claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service.

In this role you will be responsible for :

  • 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

Basic Qualifications :

  • Bachelor's Degree and 3 or more years of experience in the Claims and / or Litigation Management area. OR
  • Zurich Certified Insurance Apprentice, including an Associate Degree with 3 or more years of experience in the Claims and / or Litigation Management area. OR
  • Completion of Zurich Claims Training Program and 3 or more years of experience in the Claims and / or Litigation Management area. OR
  • High School Diploma Equivalent and 5 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 :

  • 3+ years of experience handling Workers Compensation claims with medium to high severity and exposure
  • 3+ years of Litigation Management experience
  • Jurisdictional expertise handling claims in CA
  • Self-Insured License
  • Effective verbal and written communication skills
  • Strong analytical, critical thinking, and problem solving skills
  • Solid time management, prioritization and multi-tasking skills
  • Experience collaborating in a team environment and building cross functional working relationships
  • Adept in identifying and explaining complex financial and / or actuarial concepts.
  • Ability to determine the scope and exposure for moderately complex claims
  • Demonstrates understanding of the reserving process for indemnity and expense in analyzing the potential exposure of moderately complex claims
  • Ability to develop and execute a negotiation strategy and plan for resolution
  • Ability to identify subtleties in customer / client and / or business partner interactions
  • Ability to present information necessary to propose a claim resolution to stakeholders
  • 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. 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 $64,600.00 - $105,900.00, with short-term incentive bonus eligibility set at 10%.

    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.

    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.

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