Zurich NA Workers' Compensation Claims Specialist II in Parsippany, New Jersey
Workers' Compensation Claims Specialist II
Zurich is currently looking for a Workers Compensation Claims Handler II .
This position may work out of one of the following North American offices: Philadelphia, PA; Boston, MA; or Parsippany, NJ, with moderate direction, handles workers’ compensation claims of low to moderate exposure and complexity within specific limits of authority by following established protocols to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service. This is a hybrid position with the ability to work both in office and at home. We are seeking applicants for one or more of the following jurisdictions : NJ, PA, VA, NY, MA, and/or CT.
Document claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity workers compensation commercial line claims.
Exercise judgement 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.
Ensure customer service by proactively communicating information; responding to inquiries; following customer protocols and may participating in customer marketing efforts.
Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Departs from approved vendors with manager approval, where in the best interests of the insured.
Ensure legal compliance by following state and federal laws and regulations and internal control requirements.
Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud.
Contribute to profitable growth by providing risk insight, information and trends to Business Unit or customer as needed.
Protect Zurich’s reputation by keeping claims information confidential.
Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks. And participating in professional societies.
Review assigned customer cases, prioritize case load and interpret established policies, applying discretion within authority limits in order to resolve customer issues.
Anticipate, recognize and respond timely to inquiries regarding low to medium complexity and exposure commercial claims to contribute to customer satisfaction.
Provide technical advice that enables a customer to solve a problem or improve business.
Acquire and organize the relevant evidence and information to accurately assess the value of the claim.
Collect data and document in established system to facilitate decision-making.
Adhere to local regulatory and governance requirements throughout the life of a claim to ensure decisions are made using the right standards.
Assess and appoint claims vendors within agreed authority limits aligned to the organization´s Claims Vendor Management strategy.
Determine when to solicit input from more senior colleagues or managers for more complex issues, to ensure quality and continuous learning.
Provide feedback on business processes and systems to identify opportunities for improvement.
Additional responsibilities will include:
May manage litigation by assigning counsel within the approved panel where applicable; establishing litigation plan and budget; coordinating defense lawyer activities; continuously reviewing the potential for settlement with claimant; reviewing litigation expenses and authorizing payments.
May be dedicated to handle claims for specific accounts to ensure consistency in service and enhance customer knowledge.
Bachelor’s Degree and 3 or more years of experience in the Claims or Insurance areaOR
Zurich Certified Insurance Apprentice, including an Associate Degree and 3 or more years of experience in Claims or Insurance areaOR
Completion of Zurich Claims Training Program and 3 or more years of experience in the Claims or Insurance areaOR
High School Diploma or Equivalent and 5 or more years of experience in the Claims or Insurance areaAND
Must obtain and maintain required adjuster license(s)
Knowledge of insurance regulations, markets, and products
Microsoft Office experience
Effective verbal and written communication skills
Strong analytical, critical thinking, and problem-solving skills
Solid time management, prioritization, and multi-tasking skills
Experience collaborating in a team environment and building cross functional working relationships
Adept in identifying and explaining complex financial and/or actuarial concepts.
Ability to determine the scope and exposure for moderately complex claims
Demonstrates understanding of the reserving process for indemnity and expense in analyzing the potential exposure of moderately complex claims
Ability to develop and execute a negotiation strategy and plan for resolution
Ability to identify subtleties in customer/client and/or business partner interactions
Ability to present information necessary to propose a claim resolution to stakeholders
Experinece in the following jurisdictions: PA, NY, VA, MA and/or CT
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As a condition of employment at Zurich, employees must adhere to our COVID-related health and safety protocols ( https://www.zurichna.com/careers/faq ), including, without limitation, a requirement that employees attest as to their vaccination status with a YES/NO, and upload proof of vaccination status, or negative COVID test results when allowable, to a third-party vendor. These are continuously re-evaluated and the requirements may change at any time.
A future with Zurich. What can go right when you apply at Zurich?
Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, Zurich North America has over 150 years of experience managing risk and supporting resilience. Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We serve more than 25 industries, from agriculture to technology, and we insure 90% of the Fortune 500®. Our growth strategy is not limited to our business. As an employer, we strive to provide ongoing career development opportunities, and we foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. Be a part of the next evolution of the insurance industry. Join us in building a brighter future for our colleagues, our customers and the communities we serve. Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Please clickhere (https://www.zurichna.com/careers) to learn more.
As a global company, Zurich recognizes the diversity of our workforce as an asset. We recruit talented people from a variety of backgrounds with unique perspectives that are truly welcome here. Taken together, diversity and inclusion bring us closer to our common goal: exceeding our customers’ expectations. Zurich does not discriminate on the basis of age, race, ethnicity, color, religion, sex, sexual orientation, gender expression, national origin, disability, protected veteran status or any other legally protected status. EOE disability/vet
Zurich does not accept unsolicited resumes from search firms or employment agencies. Any unsolicited resume will become the property of Zurich American Insurance. If you are a preferred vendor, please use our Recruiting Agency Portal for resume submission.
Location(s): AM - Parsippany, AM - Schaumburg, AM - Atlanta, AM - Addison
Remote Working: No
Schedule: Full Time
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