Workers Compensation Claims Specialist I (North East Region)

Zurich NA; Augusta (ME); Hybrid; USD 50,000 - 81,000; Full time

Job summary

Zurich North America is seeking a Workers Compensation Claims Specialist I for the North East Region. The role supports hybrid work from Parsippany or Boston offices, or fully remote in multiple states across the U.S., handling low-to-moderate exposure Workman’s Compensation claims.

You will document claims, determine liability and coverage, strategize case resolutions, set reserves, assess damages, negotiate settlements, and maintain quality standards within authority limits.

Qualifications

• Bachelor’s degree and 2+ years in Claims/Insurance OR
• Zurich Certified Insurance Apprentice with 2+ years in Claims/Insurance OR
• High School Diploma or equivalent with 4+ years in Claims/Insurance OR
• Zurich Claims Training Program completed with 2+ years in Claims/Insurance

Responsibilities

• Document claims file by updating data in line with best practices for commercial line claims of moderate to high exposure.
• Glean facts, analyze coverage, determine liability and policy verification.
• Develop case strategy and evaluation, escalate issues as needed for timely resolutions.
• Establish reserves within authority, estimate damages and review claims throughout the cycle.
• Negotiate settlements within authority limits and ensure adherence to quality standards.

Skills

Excellent communication skills

Analytical skills

Insurance knowledge

Education

Bachelor's degree

Zurich Certified Insurance Apprentice

High School Diploma

Zurich Claims Training Program

Tools

Microsoft Office

Job description

Workers Compensation Claims Specialist I (North East Region)

136910

Zurich is looking for an accomplished Workers Compensation Claims Specialist I 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, Vermont, Virginia, or West Virginia.

As a Claims Specialist you will handle multi-party commercial line Workman’s Compensation claims of low to moderate 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 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:

• Bachelors Degree and 2 or more years of experience in the Claims or Insurance areaOR
• Zurich Certified Insurance Apprentice including an Associate Degree and 2 or more years of experience in the Claims or Insurance areaOR
• High School Diploma or Equivalent and 4 or more years of experience in the Claims or Insurance areaOR
• Completion of Zurich Claims Training Program and 2 or more years of experience in the Claims or Insurance areaAND
• Must obtain and maintain required adjuster license(s)
• Microsoft Office experience
• Knowledge of insurance regulations, markets and products

Preferred Qualifications:

• 3+ years of experience handling claims with medium to high severity and exposure
• 3+ years of Litigation Management experience
• Familiarization with NY jurisdiction. Willingness to learn additional jurisdictions as needed
• EDI filing requirements
• MSA/Medicare knowledge
• WCCA, WCCP Designations
• Knowledge and skill of claims handling
• Negotiation experience
• Experience in line of business
• Excellent communication skills
• Analytical skills

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 49,500.00 - $81,000.00, with short-term incentive bonus eligibility set at 10%.

We offer competitive pay and comprehensive benefits for employees and their families. [Learn more about Total Rewards here (https://www.zurichna.com/careers/benefits) .]

Why Zurich?

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.

Please note: Zurich does not accept unsolicited CVs from agencies. Preferred vendors should use our Recruiting Agency Portal.

Location(s): AM - Parsippany, AM - Boston, AM - Connecticut Virtual Office, AM - Delaware Virtual Office, AM - Maine Virtual Office, AM - Massachusetts Virt. Office, AM - New Hampshire Virt. Office, AM - New Jersey Virtual Office, AM - New York Virtual Office, AM - Pennsylvania Virtual Office, AM - Rhode Island Virtual Office, AM - Vermont Virtual Office, AM - Virginia Virtual Office, AM - West Virginia Virt. Office

Remote Working: Hybrid

Schedule: Full Time

Employment Sponsorship Offered: No

EOE Disability / Veterans