Workers Compensation Claims Specialist I (North East Region)

Zurich NA; Boston (MA); Hybrid; USD 50,000 - 81,000; Full time

Job summary

Zurich North America is seeking a Workers Compensation Claims Specialist I for the Northeast region. The role offers a hybrid schedule from Parsippany or Boston offices, or a fully remote setup based in select states.

You will handle multi-party commercial Workman’s Compensation claims and deliver customer-centric service. Required qualifications include 2+ years in Claims/Insurance, an applicable degree or Zurich training, and active adjuster licensing.

Qualifications

• Bachelor's Degree with 2+ years in Claims/Insurance or equivalent Zurich certification and 2+ years in Claims/Insurance
• Associate Degree plus 2+ years in Claims/Insurance or Zurich certification plus 2+ years in Claims/Insurance
• High School Diploma or Equivalent with 4+ years in Claims/Insurance
• Zurich Claims Training Program completed with 2+ years in Claims/Insurance
• Must obtain and maintain required adjuster licenses
• Proficiency in Microsoft Office and relevant insurance regulations

Responsibilities

• Document claims files by capturing and updating data per best practices for moderate to high exposure
• Assess liability by gathering facts and applying applicable law
• Verify coverage by analyzing policy terms and determining loss within coverage
• Develop case strategy and evaluation for timely claim resolution
• Establish reserves within authority limits and review throughout the claims cycle
• Estimate damages and determine permissible ranges
• Negotiate settlements within authority limits using available tools
• Meet quality standards by following established practices

Skills

Communication skills

Analytical skills

Negotiation experience

Experience in claims handling

Microsoft Office

Education

Bachelor's Degree

Associate Degree

High School Diploma or Equivalent

Zurich Claims Training Program

Tools

EDI filing

Job description

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 area OR
• Zurich Certified Insurance Apprentice including an Associate Degree and 2 or more years of experience in the Claims or Insurance area OR
• High School Diploma or Equivalent and 4 or more years of experience in the Claims or Insurance area OR
• Completion of Zurich Claims Training Program and 2 or more years of experience in the Claims or Insurance area AND
• 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.]

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

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