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ZI
Zurich Insurance Company Ltd.
Workers Compensation Claims Handler IV
Career Insights for Claims Representative
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Based on California data
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What they do
A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.
$60,416 / year median in California
-0% projected decline
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. 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 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
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) Microsoft Office experience Knowledge of insurance regulations, markets and products
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) Microsoft Office experience Knowledge of insurance regulations, markets and products