Litigated Claims Specialist, Workers Compensation
At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to choosing your next career move. Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims employees to conduct individual work in their preferred location, while facilitating in-person connections and collaborative activities when meaningful and valuable. While the model provides a high level of flexibility and autonomy, occasional circumstances requiring in-office attendance should be expected.
Zurich North America is seeking a sharp, solutions-driven Workers' Compensation Litigated Claims Specialist to join our high-performing team. This is an opportunity to make meaningful impact at a company known for innovation and excellence in the insurance industry. We are hiring in three dynamic locations: Schaumburg, IL (hybrid schedule), Overland Park, MO (hybrid schedule) or Kansas (fully remote).
We are seeking a candidate with proven expertise in managing litigated workers' compensation claims in the following jurisdictions: Missouri, Kansas and/or Illinois. This multi-state experience is essential to effectively support our regional claims operations and drive strong outcomes.
In this position you will manage Worker's Compensation multi-party commercial line claims of moderate to high exposure and complexity within specific authority limits, to ensure that claims are handled in the most efficient, effective way while delivering a customer-centric claims service. In this role you will be responsible for:
- Document claims file by accurately capturing and updating claims data/information in compliance with best practices for moderate to high exposure and complexity workers compensation claims.
- Exercise judgement to determine compensability by gathering and analyzing relevant facts; utilizing applicable workers compensation law in a given jurisdiction.
- 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 approved outside vendors.
- Ensure legal compliance by following state and federal workers compensation 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.
Basic Qualifications:
- Bachelor's Degree and 3 or more years of experience in the Claims or Insurance area OR
- Zurich Certified Insurance Apprentice, including an Associate Degree and 3 or more years of experience in Claims or Insurance area OR
- Completion of Zurich Claims Training Program and 3 or more years of experience in the Claims or Insurance area OR
- High School Diploma or Equivalent and 5 or more years of experience in the Claims or Insurance area AND
- Must obtain and maintain required adjuster license(s)
- Knowledge of insurance regulations, markets and products
Preferred Qualifications:
- Workers Compensation experience highly preferred
- Litigation Management experience preferred
- Customer service experience
- Strong analytical, critical thinking and problem-solving skills
- Strong verbal and written communication skills
- Experience collaborating across work groups
- Ability to develop and maintain strong relationships
- Understands claims adjustment process and possesses ability to determine scope/exposure for losses
- Understands the use of vendors and how litigation strategies are developed
- Understands and applies financial and actuarial/reserving concepts
- Familiarity with negotiation strategies and experience in suggesting alternative approaches
The compensation indicated represents a nationwide market range and has not been adjusted for geographic differentials pertaining to the location where the position may be filled. The proposed salary range for this position is $58,700.00 - $96,200.00, with short-term incentive bonus eligibility set at 10%.
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.
Zurich maintains a comprehensive employee benefits package for employees as well as eligible dependents and competitive compensation. Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Zurich does not accept unsolicited resumes from search firms or employment agencies.