Workers Compensation Claims Specialist II

Job not on LinkedIn

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $65.9k - $108k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Zurich Insurance

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

🏥 Healthcare

⚖️ Legal

Consulting • Healthcare • Legal

Zurich Insurance is a global insurance and risk-management company offering a broad range of products and services including commercial and personal property & casualty insurance, life and critical-illness cover, pensions and retirement solutions, savings and investment products, claims and risk advisory, and specialty offerings such as microinsurance and travel coverage. The company also runs investment funds, sustainability and climate-focused initiatives, innovation and technology programs, and a foundation for community and environmental projects. Zurich serves both individual consumers and corporate clients across many countries, emphasizing governance, ESG reporting, digital innovation, and resilience.

📋 Description

• Handle multi-party commercial line Workers' Compensation claims of moderate to high exposure and complexity within specific authority limits • Document claims files accurately by capturing and updating claims data and information in compliance with best practices • Determine compensability by gathering and analyzing relevant facts, applying applicable law, and establishing basic principles of negligence • Determine policy verification and coverage by analyzing applicable coverage and whether the loss falls within coverage • Develop case strategy and case evaluations, escalate issues as appropriate, and work toward timely claim resolution • Establish timely reserves and conduct ongoing reviews throughout the claims cycle within authority limits • Assess damages by calculating applicable damages or ranges allowed by law • Negotiate claim settlements using appropriate strategies, tools, and resources within authority limits • Meet quality standards by following best practices • Deliver customer-centric claims service

🎯 Requirements

• Bachelor degree and 3 or more years of experience in the Claims or Insurance area; OR Zurich Certified Insurance Apprentice, including an associate degree with 3 or more years of experience; OR completion of Zurich Claims Training Program and 2 or more years of experience; OR high school diploma equivalent and 5 or more years of experience • Must obtain and maintain required adjuster license(s) • Microsoft Office experience • Knowledge of insurance regulations, markets and products • Valid California Self-Insured (SIL) License preferred • 5+ years of experience handling high-exposure Workers' Compensation claims involving complex medical, legal, and indemnity issues preferred • California jurisdictional experience preferred • Experience handling commercial claims for a major insurance carrier preferred • Experience managing litigated claims, including directing defense counsel, developing litigation strategy, participating in mediations and settlement conferences, and maintaining appropriate indemnity, medical, and expense reserves preferred • Experience handling claims transfers and transitions preferred • Knowledge of Owner-Controlled Insurance Programs (OCIPs), Wrap-Up programs, and construction-related claim handling preferred • Strong understanding of coverage analysis, compensability determinations, reserve management, and risk transfer opportunities, including contractual liability and third-party recovery preferred • Exceptional verbal and written communication skills preferred • Strong analytical, critical thinking, and problem-solving skills preferred • Ability to manage multiple priorities, collaborate cross-functionally, and build effective working relationships preferred • No employment sponsorship offered

🏖️ Benefits

• Short-term incentive bonus eligibility set at 10% • Competitive pay • Comprehensive benefits for employees and their families • Growth opportunities • Inclusive and supportive work environment