Senior Claims Specialist, Workers' Compensation

Zenith Insurance Company; Phoenix (AZ); Remote; USD 75,000 - 103,000; Full time

Job summary

An established industry player is seeking a Senior Claims Specialist to join their dynamic team. This role involves investigating and managing Workers' Compensation claims, particularly in California, and requires a strong background in claims handling. The ideal candidate will excel in communication and problem-solving, ensuring a positive experience for all parties involved. With a focus on maintaining Zenith's reputation for superior claims handling, you will work within a supportive environment that values your contributions. If you're ready to take your career to the next level in a role that offers both challenge and reward, this is the perfect opportunity for you.

Benefits

Medical, Dental and Vision Insurance

Flexible Spending Accounts

Paid Parental Leave

Life, AD&D and Disability Insurance

401(k)

Employee Share Purchase Plan (ESPP)

Education and Training Reimbursement

Paid Leave: 3 weeks/year Vacation

10 paid Company Holidays

Employee Assistance Program (EAP)

Qualifications

• 4-5+ years of Workers' Compensation Claims handling experience required.
• Must have experience handling California WC claims.

Responsibilities

• Investigate and analyze claims to determine liability and effect settlements.
• Manage assigned claims and maintain accuracy of reserves.

Skills

Workers’ Compensation Claims knowledge

Verbal and written communication

Mathematical skills

Problem-solving

Education

High School Diploma or equivalent

Bachelor’s Degree or equivalent experience

Job description

Senior Claims Specialist, Workers' Compensation

Job Category: Staff

Requisition Number: SENIO003803

Posted: December 18, 2024

Employment Type: Full-Time

Location: Las Vegas, NV 89106, USA (Remote)

Description

A Brief Overview

Investigate, analyze, and determine the extent of the company's liability concerning Claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of Claims within a certain monetary limit. All tasks are to be performed with the goal of demonstrating Zenith's superior Claims handling expertise.

This role is eligible to participate in Zenith’s REMOTE work schedule. Must have experience handling California WC claims.

What you will do

• Under limited direction, works within broad limits and authority on highly complex assignments.
• Responsible for Claims management of assigned case load 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, according to state and/or Zenith’s timeframes and guidelines.
• Sets appropriate reserves according to Zenith’s timeframes and guidelines.
• Follows appropriate procedures for system documentation to preserve data integrity.
• Monitors and maintains accuracy of reserves over the life of the claim; when new information is received re-evaluates and recommends reserves according to Zenith’s standards.
• Creates and executes action plans needed to bring case to closure.
• Completes detailed settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers’ attorneys.
• Maintains regular contact with injured workers, employers, and agents to develop positive relationships and establish credibility.
• Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
• Works productively and harmoniously with others on a consistent basis.
• Respond positively to direction and criticism of performance.
• Consistently maintain a professional and appropriate demeanor.
• Perform other duties as assigned.

Education Qualifications

• High School Diploma or equivalent required
• Bachelor’s Degree or equivalent combination of training/experience required

Experience Qualifications

• 4-5+ Years Workers’ Compensation Claims handling experience required
• Must have experience handling California WC claims

Skills and Abilities

• Advanced technical workers’ compensation Claims knowledge.
• Strong verbal and written communication skills with emphasis on telephone communication required.
• Strong math and reading skills required.
• Meets all state regulatory standards regarding licensing, continuing education, and other requirements.
• Qualified candidates may have previously held the title of Claims Adjuster, Claims Examiner, or Claims Handler.

Salary and Benefits

The expected salary range for this position is $75,772.73 to $102,207.94. Actual pay will be adjusted based on experience, geographic location, and other job-related factors as permitted by law. Qualifications may warrant placement in a different job level.

Benefits
• Medical, Dental and Vision Insurance
• Flexible Spending Accounts
• Paid Parental Leave
• Life, AD&D and Disability Insurance
• 401(k), Employee Share Purchase Plan (ESPP)
• Education and Training Reimbursement
• Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave
• 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays
• Employee Assistance Program (EAP)

Zenith Insurance Company is an equal opportunity employer and considers all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristic. In compliance with California law, we are committed to fair hiring practices. Pursuant to the California Fair Chance Act (AB 1008), we will consider qualified applicants with criminal histories in a manner consistent with the law.