Senior Workers' Comp Claims Specialist - CA Claims

Overview

Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of Claims within a certain monetary limit. All tasks are to be performed with the goal of demonstrating Zenith's superior Claims handling expertise.

Responsibilities

• Works within broad limits and authority on highly complex assignments.
• Responsible for Claims management of assigned case load within guidelines of published performance standards.
• Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith’s timeframes and guidelines.
• Sets appropriate reserves according to Zenith’s timeframes and guidelines.
• Follows appropriate procedures for system documentation to preserve data integrity.
• Maintains accuracy of reserves over the life of the claim; when new information is received re-evaluates and recommends reserves according to Zenith’s standards.
• Creates and executes action plans needed to bring case to closure.
• Completes detailed settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers’ attorneys.
• Maintains regular contact with injured workers, employers and agents to develop positive relationships and establish credibility.
• Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
• Works productively and harmoniously with others on a consistent basis.
• Respond positively to direction and criticism of performance.
• Consistently maintain professional and appropriate demeanor.
• Perform other duties as assigned.

Qualifications

• Must have California Workers' Compensation Claims Adjuster Certification/ designation.
• Education: High School Diploma Or equivalent required Bachelor’s Degree or equivalent required
• Work Experience: 5+ years Workers’ Compensation Claims handling experience required CA workers Comp claims experience is a must
• Knowledge, Skills, And Abilities: Advanced technical workers’ compensation claims knowledge Strong verbal and written communication skills with emphasis on telephone communication required Strong math and reading skills required Meets all state regulatory standards regarding licensing, continuing education, and other requirements.

Pay, Benefits, And Other Information

The expected salary range for this position is $94,502.68 - $127,972.38. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law. Qualifications may warrant placement in a different job level.

• Benefits: Medical, Dental and Vision Insurance Flexible Spending Accounts Paid Parental Leave Life, AD&D and Disability Insurance 401(k), Employee Share Purchase Plan (ESPP) Education and Training Reimbursement Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays Employee Assistance Program (EAP)

For more information, review details on the Benefits page of our Career Site: https://www.thezenith.com/careers/benefits/