Senior Workers' Compensation Claims Specialist
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Workers Compensation Claims Specialist managing single and multi-party commercial claims for Zurich. Ensuring timely resolution and compliance with best practices in claims management.
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 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
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.
- Texas 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.
- Must obtain and maintain required adjuster license(s).
- Microsoft Office experience
- Knowledge of insurance regulations, markets and products.
Benefits:
- Competitive pay and comprehensive benefits for employees and their families
- Bonuses
- Merits increases
Similar Jobs
Complex Liability Claims Specialist
Claims Specialist managing complex commercial liability claims and litigation at Zurich. Requires significant experience in claims management across multiple jurisdictions.
BI Claims Adjuster, Courier Delivery
Seeking Commercial Transportation Resolution Specialists for customer claims in an insurtech firm. Responsibilities include managing claims and delivering high-quality customer service.
APD Claims Adjuster, Courier Delivery
Commercial Transportation Claims Adjuster role at tech-driven insurtech company specializing in AI for claims processes. Managing customer interactions and optimizing claims outcomes through technology and empathy.
Commercial Bodily Injury Claims Adjuster
Resolution Specialist managing transportation-related claims for insurtech startup. Providing customer service and collaborating with legal teams to ensure compliance with state regulations and procedures.
Casualty Bodily Injury Claims Adjuster
Bodily Injury Claims Adjuster responsible for investigating complex automobile claims. Mentoring junior employees and determining coverage, liability, and damages in Texas for National General.
Claims Analyst
Claims Analyst consulting members on billing related issues in a healthcare navigation business. Advocating for members and resolving post-service coverage questions with carriers and providers.
Litigation Claims Adjuster, Rideshare
Rideshare Bodily Injury Litigation Adjuster managing litigated files for Reserv. Investigating claims, negotiating resolutions, and collaborating with product teams in a dynamic environment.
Senior Claims Adjuster, Large Loss
Senior Claims Adjuster managing complex property claims for Kin, a remote-first insurance company. Investigating, negotiating, and resolving losses while supporting homeowners in critical moments.
Major Case Unit Claims Adjuster, Rideshare
Claims Adjuster managing high-exposure rideshare cases and litigation strategy for a leading insurtech. Collaborating with stakeholders to deliver timely and thoughtful outcomes in claims resolution.
Claims Specialist I – Provider Claims
Claims Specialist at IEHP responsible for evaluating provider claims and resolving disputes. Ensuring compliance with standards while issuing resolutions and adjustments in claims processing.
Claims Adjuster – Commercial Auto Excess Casualty
Claims Adjuster managing high-severity commercial auto liability claims with cutting-edge AI tools. Collaborating with insurers and internal teams to drive optimal outcomes and enhance claims efficiency.
APD Claims Adjuster, Rideshare
Claims Adjuster managing rideshare auto physical damage claims at an insurtech company. Handling high-volume claims with a focus on customer service and process refinement.
Claims Representative
Claims Representative at Mercury Insurance investigating and resolving auto and property damage claims. Providing exceptional customer service in a team environment with a high volume of calls.
Workers Compensation Claims Analyst
Workers Compensation Claims Analyst handling medical only claims and limited lost time claims for Advocate Health. Collaborating with case managers, attorneys, and vendors while adhering to regulatory compliance requirements.
Claims Processor
Claims Processor overseeing medical records and wellness claims adjudication for Fetch pet insurance. Organizing documentation and providing administrative support for the Specialty Claims team.
Liability Claims Associate, NY or HI Licensing Required
Analyze lower-level liability claims within Sedgwick’s standards. Collaborate to determine benefits due while maintaining professional client relationships.
Claims Examiner – Workers Compensation, AZ, CO, UT Jurisdictions
Claims Examiner adjudicating complex customer claims at industry-leading risk and claims administration partner Sedgwick. Applying workers compensation examiner knowledge to deliver innovative solutions and exceptional client service.
Claims Examiner
Claims Examiner reviewing and processing death claims for OSGLI. Managing pending claims and corresponding with various parties throughout the claims process.
Claims Examiner
Claims Examiner at Thrivent examining claims for eligibility and ensuring compliance with regulatory standards. Collaborating with peers and providing support to Associate Claims Examiners in claim decisions.
Claims Examiner II
Claims Examiner II at NICO investigating property damage and bodily injury claims under insurance contracts. Ensuring compliance with claims handling laws and collaborating with legal departments as necessary.