Hybrid WC Claims Specialist

Zenith Insurance Company (United States); San Diego (CA); Hybrid; USD 78,000 - 106,000; Full time

Benefits offered by this job

Medical, Dental and Vision Insurance

401(k) and ESPP

Education and Training Reimbursement

Paid Holidays and Personal Days

EAP

Job summary

Zenith Insurance Company, a Workers' Compensation specialist, seeks a Claims professional to investigate, analyze, and determine liability, and to settle claims within authority. You will interview medical professionals, estimate settlements, and maintain case documentation to demonstrate Zenith's expertise.

The role requires 3+ years in Workers' Comp or insurance, strong communication, and compliance with licensing standards.

Qualifications

• Strong verbal and written communication skills with emphasis on telephone communication.
• Meets all state regulatory standards regarding licensing, continuing education, and other requirements.
• 3+ years Workers' Comp claim or insurance experience required.
• Bilingual Spanish is a plus.

Responsibilities

• Under technical direction, works within significant limits and authority on assignments of higher technical complexity and coordination.
• Responsible for Claims management of assigned cases within guidelines of published performance standards.
• Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment.
• Sets appropriate reserves according to Zenith’s timeframes and guidelines.
• Monitors and maintains accuracy of reserves over the life of the claim; re-evaluates with new information.
• Creates and executes action plans to bring cases to closure.
• Completes detailed settlement evaluations and negotiates settlements within authority.
• Maintains regular contact with injured workers, employers and agents to build relationships.

Skills

Verbal communication

Written communication

Math skills

CA licensing knowledge

Education

High School Diploma or GED

Bachelor’s Degree preferred

CA hours up to date

Self-insured designation preferred

Job description

Zenith Insurance Company, a Workers' Compensation specialist, seeks a Claims professional to investigate, analyze, and determine liability, and to settle claims within authority. You will interview medical professionals, estimate settlements, and maintain case documentation to demonstrate Zenith's expertise.

The role requires 3+ years in Workers' Comp or insurance, strong communication, and compliance with licensing standards.