Worker's Compensation Claims Handler IV

Zurich 56 Company Ltd; California (MO); Hybrid; USD 83,000 - 137,000; Full time

Job summary

Zurich North America seeks an experienced Workman’s Compensation Claims Handler IV to manage moderate to high exposure California workers’ compensation claims. This remote/hybrid role requires jurisdictional knowledge and the ability to handle complex claims with careful data capture, case strategy, and settlement negotiations.

Responsibilities include analyzing compensability and coverage, reserving within authority, and escalating as needed to achieve timely resolutions.

Qualifications

• Bachelor’s degree with 6+ years in claims or litigation management, or JD with 2+ years in claims/litigation management.
• Zurich apprenticeship path with associative degree plus 6+ years in claims/litigation management.
• Zurich training program completion with 5+ years in claims/litigation management.
• High school diploma equivalent with 8+ years in claims/litigation management.
• Must obtain and maintain required adjuster licenses and knowledge of insurance regulations.

Responsibilities

• Document claims file by accurately capturing and updating data per best practices for moderate to high exposure claims.
• Determine compensability by analyzing facts and applying relevant laws.
• Evaluate coverage by analyzing policy documents.
• Develop case strategy and escalation to resolve claims timely.
• Establish reserves within authority and review throughout the claims cycle.
• Assess exposure based on facts, statutes, and experience.
• Negotiate settlements within authority limits.
• Meet quality standards by following best practices.

Skills

Verbal and written communication

Analytical thinking

Multitasking

Cross-functional collaboration

Education

Bachelor’s degree + 6+ years in Claims/Litigation

Juris Doctor + 2+ years in Claims/Litigation

Zurich Certified Insurance Apprentice + 6+ years

High School Diploma + 8+ years

Job description

Zurich is seeking an experienced Workman’s Compensation Claims Handler IV to join our team! We are specifically seeking candidates who can work from California on a remote or hybrid basis (2 days/month in office)

To handle Workers’ 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. Jurisdictional knowledge in California Workers Compensation is required.

• 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
  

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 5 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:

• 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 moderate to complex claims
• Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of moderate to complex claims
• Ability to determine the scope and exposure for moderate to complex claimsAbility to leverage knowledge of industry trends and relationships to provide high-quality customer service.
• Ability to effectively communicate coverage determinations to customers/clients/brokers for moderate to complex claims
• Ability to direct counsel on an ongoing basis to guide the course of moderate to 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 Rewardshere .]

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.

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