Sr. Claims Specialist, Workers Compensation

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About the role

Zurich North America Claims seeks an experienced Workers’ Compensation Claims Specialist to join our team. This is a hybrid role based out of Las Vegas, NV or remote in the U.S. for those with expertise in handling Jurisdiction of NV.

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.
• Develop a case strategy; develop a case evaluation; escalate issues as appropriate.
• Estimate and validate value of claims; establish timely reserves and perform ongoing review throughout claims cycle within authority limit.
• Calculate applicable damages or range of damages allowed by law; assess damages.
• Establish appropriate negotiation strategy and utilize available tools and resources within authority limits; negotiate settlement of claim.

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.

Qualifications

• Basic Qualifications: Must obtain and maintain required adjuster license(s); Microsoft Office experience; knowledge of insurance regulations, markets and products.
• Preferred Qualifications: 6+ experience handling high severity Workers Compensation claims; 6+ years of experience in litigation management; Jurisdiction expertise handling state of Nevada; 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; Proactive sharing and promoting 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.

Skills

• Knowledge of insurance regulations, markets and products.
• 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.
• Proactive sharing and promoting 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.

Benefits

Zurich offers competitive pay and comprehensive benefits for employees and their families. [Learn more about Total Rewards here.]

Pay

Your pay at Zurich is based on your role, location, skills, and experience. We follow local laws to ensure fair compensation. You may also be eligible for bonuses and merit increases. If your expectations are above the listed range, we still encourage you to apply your unique background matters to us. The pay range shown is a national average and may vary by location. The proposed Salary range for this position is $75,800.00-124,100.00, with short-term incentive bonus eligibility set at {15%}.

Sponsorship

We offer sponsorship for this role. Please note: Zurich does not accept unsolicited CVs from agencies. Preferred vendors should use our Recruiting Agency Portal.

Location

Location(s): AM - Las Vegas, AM - Remote Work (US)

Remote Working

Schedule: Hybrid

Employment

Sponsorship Offered: No

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