Workers' Compensation Claims Specialist
Zenith Insurance Company is seeking a Workers' Compensation Claims Specialist to investigate, analyze, and determine the extent of the company's liability concerning claims. The role involves managing claims, negotiating settlements, and maintaining relationships with injured workers and other stakeholders.
Responsibilities
- Under technical direction, works within significant limits and authority on assignments of higher technical complexity and coordination
- Responsible for Claims management of assigned cases within guidelines of published performance standards
- Opens new Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith’s timeframes and guidelines
- Sets appropriate reserves according to Zenith’s timeframes and guidelines
- Follows appropriate procedures for system documentation to preserve data integrity
- Monitors and maintains accuracy of reserves over the life of the claim; when new information is received re-evaluates and recommends reserves according to Zenith’s standards
- Creates and executes action plans needed to bring case to closure
- Completes detailed settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers’ attorneys
- Maintains regular contact with injured workers, employers and agents to develop positive relationships and establish credibility
- Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions
- Works productively and harmoniously with others on a consistence basis
- Respond positively to direction and criticism of performance
- Consistently maintain professional and appropriate demeanor
- Perform other duties as assigned
Skills
- High School Diploma Or equivalent
- Expierance with Pennsylvania (PA) and/or New Jersey (NJ) jurisdictions
- Previous workers' compensation experience
- Basic technical workers' compensation Claims knowledge
- Strong verbal and written communication skills with emphasis on telephone communication
- Strong math and reading skills
- Meets all state regulatory standards regarding licensing, continuing education, and other requirements
- Bachelor's Degree or equivalent combination of training/experience
- 1-7 years claim or insurance experience
Benefits
- Medical, Dental and Vision Insurance
- Flexible Spending Accounts
- Paid Parental Leave
- Life, AD&D and Disability Insurance
- 401(k), Employee Share Purchase Plan (ESPP)
- Education and Training Reimbursement
- Paid Leave: 3 weeks/year Vacation, 2 weeks/year Sick Leave
- 10 paid Company Holidays, 2 Personal Days, 2 Floating Holidays
- Employee Assistance Program (EAP)
Company Overview