Senior CA Workers' Comp Claims Handler – Remote

Zurich North America; California (MO); Hybrid; USD 83,000 - 137,000; Full time

Benefits offered by this job

Bonus eligibility

Job summary

Zurich North America seeks an experienced Workman’s Compensation Claims Handler IV to join our team in California on a remote or hybrid basis (2 days per month in office). You will handle moderate to high exposure workers’ compensation claims, applying CA laws and policy terms to determine compensability and coverage, and developing case strategy for timely resolutions.

The role requires strong analytical skills, jurisdictional knowledge, and the ability to negotiate settlements within authority

Qualifications

• Bachelor’s Degree and 6+ years of experience in the Claims and/ or Litigation Management area.
• Juris Doctor and 2+ years of experience in the Claims and/ or Litigation Management area.
• Zurich Certified Insurance Apprentice, including an Associate Degree with 6+ years of experience in the Claims and/ or Litigation Management area.
• Completion of Zurich Claims Training Program and 5+ years of experience in the Claims and/ or Litigation Management area.
• High School Diploma Equivalent and 8+ years of experience in the Claims and/ or Litigation Management area.

Responsibilities

• Document claims file by accurately capturing and updating claims data/information in compliance with best practices for workers compensation claims of moderate to high exposure and complexity.
• Exercise judgment to determine compensability by gathering and analyzing relevant facts and utilizing applicable laws and statute.
• Exercise judgment to evaluate coverage by analyzing policy documents for location and date of loss.
• 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 for most probable exposure and claim outcome.
• Assess exposure or range of exposure based on the case facts, jurisdictional statute, and claims experience.
• 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

Skills

Microsoft Office

Insurance regulations knowledge

Strong communication

Education

Bachelor’s Degree + 6+ years Claims/Lit Mgmt

Juris Doctor + 2+ years Claims/Lit Mgmt

Zurich Certified Insurance Apprentice + 6+ years

Zurich Claims Training Program + 5+ years

High School Diploma Equivalent + 8+ years

Job description

Zurich North America seeks an experienced Workman’s Compensation Claims Handler IV to join our team in California on a remote or hybrid basis (2 days per month in office). You will handle moderate to high exposure workers’ compensation claims, applying CA laws and policy terms to determine compensability and coverage, and developing case strategy for timely resolutions.

The role requires strong analytical skills, jurisdictional knowledge, and the ability to negotiate settlements within authority