Senior Claims Specialist, Workers Compensation

This is a fully remote position, open to applicants in California.

📋 Description

• Manage both single and multi-party commercial Workers’ Compensation claims that carry moderate to high exposure and complexity within established authority limits.

• Accurately document claims files by capturing and updating essential claims data and information.

• Assess liability by gathering and analyzing relevant facts, applying applicable laws, and determining principles of negligence.

• Verify policy details and ascertain coverage by reviewing relevant claim coverage.

• Formulate case strategies and evaluations to ensure timely resolution of claims, escalating issues when necessary.

• Set timely reserves and monitor them throughout the duration of the claims cycle.

• Evaluate damages and compute applicable damage amounts or legally permissible ranges.

• Negotiate claim settlements using suitable strategies and available resources within authority limits.

• Adhere to quality standards by implementing best practices.

• Provide customer-focused claims service.

⛳️ Requirements

• Bachelor’s Degree with 6 or more years of experience in Claims and/or Litigation Management; OR Juris Doctor with 2 or more years of experience; OR Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience; OR completion of the Zurich Claims Training Program with 6 or more years of experience; OR High School Diploma Equivalent with 8 or more years of experience.

• Required to obtain and maintain necessary adjuster license(s).

• Proficient in Microsoft Office applications.

• Familiarity with insurance regulations, markets, and products.

• Candidates working remotely from California are especially encouraged to apply; applicants from other locations may be considered if currently licensed in California.

• Preferred: 6+ years of experience managing high-severity Workers’ Compensation claims.

• Preferred: 6+ years in litigation management.

• Preferred: active California adjuster’s license.

• Preferred: experience with an insurance carrier.

• Preferred: strong verbal and written communication abilities.

• Preferred: excellent analytical, critical thinking, problem-solving, multitasking, and prioritization skills.

• Preferred: experience collaborating in team settings and building cross-functional relationships.

• Preferred: capacity to analyze insurance policies, reserving processes, complex claim exposures, financial/actuarial trends, coverage determinations, and litigation strategies.

• Employment sponsorship is not available.

🏝️ Benefits

• Eligibility for a short-term incentive bonus set at 15%.

• Competitive salary.

• Comprehensive benefits package for employees and their families.

• Opportunities for growth, inclusion, and a supportive work environment.

• Potential for merit-based salary increases.