Sr. Claims Specialist, Workers Compensation (NE Region)

This opportunity offers a hybrid work schedule from our Parsippany, NJ or Boston, MA offices, or the flexibility to work fully remotely from one of the following states: Maine, Vermont, New Hampshire, Massachusetts, Connecticut, Rhode Island, New York, Pennsylvania, New Jersey, Virginia, Washington, D.C., or Delaware.

About the role

The Senior Workers Compensation Claims Specialist will handle multi-party commercial line Workers’ Compensation claims of moderate to high exposure and complexity within specific authority limits, ensuring claims are managed efficiently and effectively while delivering a customer-centric claims service.

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 toward timely resolution of claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.
• Establish timely reserves and perform ongoing review throughout the claims cycle within authority limits by estimating and validating the value of claims.
• Assess damages by calculating applicable damages or range of damages allowed by law.
• Negotiate settlement of claims by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.
• Meet quality standards by following best practices.

Requirements

Basic Qualifications

• Bachelor’s Degree and 6 or more years of experience in the Claims and/or Litigation Management area.
• OR Juris Doctor and 2 or more years of experience in the Claims and/or Litigation Management area.
• OR Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/or Litigation Management area.
• OR Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/or Litigation Management area.
• OR High School Diploma or 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.

Preferred Qualifications

• 6+ years of experience in the Workers Compensation line of business.
• 6+ years of experience handling litigation management.
• Specializing in some combination of the following jurisdictions: NJ, NY, PA, VA, DC, or DE.
• Learn and handle additional jurisdictions as needed.
• EDI filing requirements.
• MSA/Medicare knowledge.
• WCCA, WCCP Designations.
• Knowledge and skill of claims handling.
• Negotiation experience.
• Experience in line of business.
• Excellent communication skills.
• Analytical skills.

Pay

The proposed salary range for this position is $75,800–$124,100, with short-term incentive bonus eligibility set at 15%.

Benefits

We offer competitive pay and comprehensive benefits for employees and their families. Learn more about Total Rewards here.