Sr. Claims Specialist, Workers Compensation (Maine)

Zurich 56 Company Ltd; Parsippany-Troy Hills (NJ); Hybrid; USD 74,000 - 122,000; Full time

Job summary

A leading insurance firm is seeking a Sr. Claims Specialist for the Workers Compensation line to manage complex claims with a focus on exceptional customer service. The role offers a hybrid work environment from Parsippany or Boston, or fully remote options in several states. Ideal candidates will have extensive experience in claims management, possess required adjuster licenses, and demonstrate strong analytical skills.

Qualifications

• 6+ years of experience in Claims and/or Litigation Management.
• Must obtain and maintain required adjuster license(s).
• Knowledge of insurance regulations, markets, and products.

Responsibilities

• Document claims file by accurately capturing and updating claims data.
• Determine liability by gathering and analyzing relevant facts.
• Negotiate settlement of claims by establishing an appropriate negotiation strategy.

Skills

Claims Management

Litigation Management

Negotiation

Analytical Skills

Knowledge of Insurance Regulations

Education

Bachelor's Degree

Juris Doctor

High School Diploma Equivalent

Job description

Sr. Claims Specialist, Workers Compensation (Maine)

Zurich is looking for an accomplished Workers Compensation Sr. Claims Specialist for our Northeast region. This position offers a hybrid work schedule from our Parsippany or Boston offices, or a fully remote setup based in one of the following states: Connecticut, Delaware, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, or Vermont.

The Senior Workers Compensation Claims Specialist will handle 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.

Responsibilities

• 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 toward timely resolution of claims by developing case strategy, evaluating the case, and escalating issues as appropriate.
• Establish timely reserves and perform ongoing review throughout the claims cycle within authority limits by estimating and validating the value of claims.
• Assess damages by calculating applicable damages or range of damages allowed by law.
• Negotiate settlement of claim by establishing an 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.
• Juris Doctor and 2 or more years of experience in the Claims and/or Litigation Management area.
• Zurich Certified Insurance Apprentice, including an Associate Degree with 6 or more years of experience in the Claims and/or Litigation Management area.
• Completion of Zurich Claims Training Program and 6 or more years of experience in the Claims and/or Litigation Management area.
• High School Diploma Equivalent and 8 or more years of experience in the Claims and/or Litigation Management area.
• Must obtain and maintain required adjuster license(s).
• Knowledge of insurance regulations, markets and products.

Preferred Qualifications

• 6+ years of experience in the Workers Compensation line of business.
• 6+ years of experience handling litigation management.
• Specializing in Maine lost time & litigated claims.
• EDI filing requirements.
• MA, CT jurisdictional knowledge & license required.
• Expertise in managing all jurisdictions within the New England states.
• WCCA, WCCP Designations.
• Knowledge and skill of claims handling.
• Experience in line of business.
• Analytical skills.

Compensation

The proposed salary range for this position is $74,300.00 – $121,700.00, with short‑term incentive bonus eligibility set at 15%.

EEO Statement

Zurich in North America is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race/ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.