Zurich NA Sr. Claims Specialist - Complex Claims in Rancho Cordova, California
Sr. Claims Specialist - Complex Claims
What can go right when you can grow your career?
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, we have over 150 years of experience, serve more than 25 industries, and insure 90% of the Fortune 500®. Zurich strives to provide ongoing career development opportunities so you can reach your full potential and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. With the support of people like you, we are optimistic about leading the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.
Zurich is currently looking for a Sr. Claims Specialist - Complex Claims. This position may work out of one of the following North American offices: Schaumburg, Omaha, Atlanta, Woodland Hills, Rocky Hill, Addison, Overland Park, New York City, Rancho Cordova, Parsippany
Resolve claims at the highest authority levels on personal or commercial claim assignments reflecting the highest degree of technical complexity, in the most effective, efficient way while delivering a customer-centric claims service.
Additional responsibilities will include:
Update claims file by accurately capturing and updating claims data/information in compliance with best practices for personal or commercial claim assignments reflecting the highest degree of technical complexity and exposure
Use judgment to determine liability by gathering and analyzing relevant facts, utilizing applicable law and establishing basic principles of negligence
Use judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage
Ensure a timely resolution to claims by developing case strategy, developing a case evaluation and 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
Ensure customer service by proactively communicating information, responding to inquiries following customer service protocols
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
Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Depart 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
Serve as a technical resource by mentoring lower level claims professionals and sharing technical knowledge related to specific Line Of Business expertise
Protect the organization´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
Contribute to the team effort by accomplishing related results and participating in projects as needed
Identify and resolve problems by referring to policies, procedures, and standards to ensure consistency and quality of solutions
Assess and appoint claims vendors within agreed authority limits aligned to the organization´s Claims Vendor Management strategy
Act as a technical expert for own team, and internal business partners and provides insights to help improve product offerings, risk assessments and policy language
Determine when to solicit input from more senior colleagues or managers for more complex issues, to ensure quality and continuous learning
Bachelors Degree and 8 or more years of experience in the Claims Technical areaOR
Juris Doctor and 4 or more years of experience in the Claims and Litigation Management area.OR
High School Diploma or Equivalent and 10 or more years of experience in the Claims and/or Litigation Management areaOR
Zurich Certified Insurance Apprentice, including an Associate Degree with 8 or more years of experience in the Claims and/or Litigation Management areaAND
Must obtain and retain required adjuster license
Microsoft Office experience
Knowledge of insurance regulations, markets, and products
AIC, SCLA or CPCU
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
Proactively shares and promotes 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
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 - Schaumburg, AM - Atlanta, AM - New York, AM - Overland Park, AM - Parsippany, AM - Rancho Cordova, AM - Addison, AM - Omaha, AM - Rocky Hill, AM - Woodland Hills
Remote Working: No
Schedule: Full Time
Linkedin Recruiter Tag: #LI-BW1