Claims Specialist II

Zurich Insurance Company Ltd. seeks a Claims Specialist II, Workers' Compensation to manage a portfolio of complex workers' comp claims from first notice through resolution. You will investigate claims, analyze coverage, set and adjust reserves, and coordinate medical management while ensuring compliance with state regulations. You'll collaborate with employers, injured workers, medical providers, and attorneys to drive timely, fair outcomes, control loss costs, and deliver excellent customer service in a collaborative, learning-focused culture.

Responsibilities

• Manage a caseload of workers' compensation claims from first notice through closure
• Conduct thorough investigations, obtain statements, and analyze coverage and liability
• Establish, monitor, and adjust claim reserves in line with company guidelines
• Coordinate medical management, return-to-work plans, and vendor services
• Negotiate settlements with injured workers, employers, and attorneys
• Ensure compliance with state workers' compensation statutes and internal policies
• Partner with defense counsel on litigated files and develop legal strategies
• Maintain accurate documentation within claims management systems
• Communicate proactively with employers, brokers, and internal stakeholders
• Identify trends and contribute to process improvements and loss cost control

Required Skills

• Workers' compensation claims handling
• Liability and coverage analysis
• Medical terminology and billing review
• Claim investigation and statement taking
• Negotiation and settlement
• Litigation management and attorney coordination
• Use of claims management systems (e.g., Guidewire)
• Regulatory and jurisdictional compliance
• Reserving and financial accuracy
• Customer service and stakeholder communication