Sr. Claims Specialist, Workers Compensation

Zurich Insurance; California; Hybrid; USD 83,000 - 137,000; Full time

Benefits offered by this job

Comprehensive benefits

Short-term incentive bonus eligibility

Job summary

Zurich Insurance is seeking a seasoned Senior Workers' Compensation Claims Specialist to handle complex WC claims from a California remote setup. The role requires strong experience in high-exposure claims, multi-party files, and a solid grasp of coverage and liability principles.

The position emphasizes timely case strategy, reserve management, and effective negotiation within authority limits, complemented by Zurich’s comprehensive benefits and incentive opportunities.

Qualifications

• Bachelor’s Degree and 6+ years in Claims or Litigation Management, or JD with 2+ years.
• Zurich Certification or equivalent training with substantial claims experience.
• High school diploma with 8+ years in claims and ability to obtain required licenses.

Responsibilities

• Document claims file with accurate data per best practices for single and multi-party claims.
• Gather facts, assess liability using applicable law, and establish negligence principles.
• Verify policy coverage and determine if loss falls within coverage.
• Develop case strategy and evaluation to resolve claims timely.
• Establish reserves within authority and review claims throughout the cycle.
• Assess damages and calculate the applicable amounts.
• Negotiate settlements within authority limits using available tools.
• Meet quality standards by following best practices.

Education

Bachelor’s Degree or higher in a related field

Juris Doctor (JD) or equivalent

Zurich Claims Training Program/Certifications

Hold or obtain adjuster license(s)

Knowledge of insurance regulations

Job description

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Sr. Claims Specialist, Workers Compensation

137875

Zurich is seeking an experienced Workman’s Compensation Sr. Claims Specialist to join our team! We are specifically seeking candidates who can work remotely from California. However, we are open to considering applicants from other locations if they are currently licensed in the state of California.

The Senior Workers Compensation Claims Specialist will handle single and multi-party commercial line Workman’s Compensation 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 single and multi-party personal or commercial line claims of moderate to high exposure and complexity.
• Exercise judgment to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.
• 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

Basic Qualifications:

• Bachelor’s Degree and 6 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/ or Litigation Management area.
  OR
• High School Diploma Equivalent and 8 or more years of experience in the Claims and/ or Litigation Management area.
  AND
• Must obtain and maintain required adjuster license(s)
• Knowledge of insurance regulations, markets and products

Preferred Qualifications:

• 6+ years of experience handling high-severity Workers' Compensation claims
• 6+ years of experience in litigation management
• Currently holds an active adjusters license in the state of California
• Experience working for a carrier
• Effective verbal and written communication skills
• Strong analytical, critical thinking and problem-solving skills
• Strong multi-tasking and prioritization skills
• Experience collaborating in a team environment and building cross functional working relationships
• Proactively shares and promotes sharing of insights
• Ability to gather unique perspectives from other teams/functions to optimize outcomes.
• Understands, analyzes, and applies the component parts of an insurance policy for complex claims
• Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims
• Ability to determine the scope and exposure for complex claims
• Ability to leverage trend and relationships to provide high-quality customer service
• Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts.
• Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims
• Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies

Your pay at Zurich is based on your role, location, skills, and experience. We follow local laws to ensure fair compensation. You may also be eligible for bonuses and merit increases. If your expectations are above the listed range, we still encourage you to apply—your unique background matters to us. The pay range shown is a national average and may vary by location. The proposed Salary range for this position is $83,400.00 - $136,500.00, with short-term incentive bonus eligibility set at 15%.

We offer competitive pay and comprehensive benefits for employees and their families. [Learn more about Total Rewards here .]

At Zurich, we value your ideas and experience. We offer growth, inclusion, and a supportive environment—so you can help shape the future of insurance. Zurich North America is a leader in risk management, with over 150 years of expertise and coverage across 25+ industries, including 90% of the Fortune 500®.

Join us for a brighter future—for yourself and our customers.

Zurich in North America does not discriminate based on race, ethnicity, color, religion, national origin, sex, gender expression, gender identity, genetic information, age, disability, protected veteran status, marital status, sexual orientation, pregnancy or other characteristics protected by applicable law. Equal Opportunity Employer disability/vets.

Zurich complies with 18 U.S. Code § 1033.

Location(s): AM - California Virtual Office
Remote Working: Yes
Schedule: Full Time
Employment Sponsorship Offered:No
Linkedin Recruiter Tag: #LI-MD1 #LI-ASSOCIATE #LI-REMOTE