Sr. Claims Specialist in Schaumburg

Sr. Claims Specialist – Complex Claims

Company: Zurich Insurance Group Ltd

Location: Schaumburg

Experience: 8-10+ years

 

 

Job Description

 

Now is the time to move forward and make a difference. At Zurich, we want you to share your unique perspectives, experiences and ideas so we can grow and drive sustainable change together. As part of a leading global organization, we have over 150 years of experience, serve more than 25 industries, and insure 90% of the Fortune 500®. Zurich strives to provide ongoing career development opportunities so you can reach your full potential and foster an environment where voices are diverse, behaviors are inclusive, actions drive equity, and our people feel a sense of belonging. With the support of people like you, we are optimistic about leading the next evolution of the insurance industry. Join us in building a brighter future for our people, our customers and the communities we serve.

 

 

 

Zurich is currently looking for a Sr. Claims Specialist – Complex Claims. This position may work out of one of the following North American offices:  Schaumburg, Omaha, Atlanta, Woodland Hills, Rocky Hill, Addison, Overland Park, New York City, Rancho Cordova, Parsippany

 

 

 

Resolve claims at the highest authority levels on personal or commercial claim assignments reflecting the highest degree of technical complexity, in the most effective, efficient way while delivering a customer-centric claims service.

 

 

 

Additional responsibilities will include:

 

 

 

Update claims file by accurately capturing and updating claims data/information in compliance with best practices for personal or commercial claim assignments reflecting the highest degree of technical complexity and exposure

 

Use judgment to determine liability by gathering and analyzing relevant facts, utilizing applicable law and establishing basic principles of negligence

 

Use judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage

 

Ensure a timely resolution to claims by developing case strategy, developing a case evaluation and 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

 

Ensure customer service by proactively communicating information, responding to inquiries following customer service protocols

 

Manage litigation by assigning counsel within the approved panel where applicable, establishing litigation plan and budget, coordinating defense lawyer activities, continuously reviewing the potential for settlement with claimant, reviewing litigation expenses and authorizing payments

 

Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Depart from approved vendors with manager approval, where in the best interests of the insured

 

Ensure legal compliance by following state and federal laws and regulations and internal control requirements

 

Refer claim to subrogation and fraud teams by identifying potential subrogation and fraud

 

Contribute to profitable growth by providing risk insight, information and trends to Business Unit or customer as needed

 

Serve as a technical resource by mentoring lower level claims professionals and sharing technical knowledge related to specific Line Of Business expertise

 

Protect the organization´s reputation by keeping claims information confidential

 

Maintain professional and technical knowledge by participating in educational opportunities, staying current with industry trends, establishing personal networks and participating in professional societies

 

Contribute to the team effort by accomplishing related results and participating in projects as needed

 

Identify and resolve problems by referring to policies, procedures, and standards to ensure consistency and quality of solutions

 

Assess and appoint claims vendors within agreed authority limits aligned to the organization´s Claims Vendor Management strategy

 

Act as a technical expert for own team, and internal business partners and provide insights to help improve product offerings, risk assessments and policy language

 

Determine when to solicit input from more senior colleagues or managers for more complex issues, to ensure quality and continuous learning

 

Basic Qualifications:

 

Bachelor’s Degree and 8 or more years of experience in the Claims Technical area

OR

 

Juris Doctor and 4 or more years of experience in the Claims and Litigation Management area.

OR

 

High School Diploma or Equivalent and 10 or more years of experience in the Claims and/or Litigation Management area

OR

 

Zurich Certified Insurance Apprentice, including an Associate Degree with 8 or more years of experience in the Claims and/or Litigation Management area

AND

 

Must obtain and retain required adjuster license

 

Microsoft Office experience

 

Knowledge of insurance regulations, markets, and products

 

Preferred Qualifications:

 

AIC, SCLA or CPCU

 

Effective verbal and written communication skills

 

Strong analytical, critical thinking and problem-solving skills

 

Strong multi-tasking and prioritization skills

 

Experience collaborating in a team environment and building cross functional working relationships

 

Proactively shares and promotes sharing of insights

 

Ability to gather unique perspectives from other teams/functions to optimize outcomes

 

Understands, analyzes, and applies the component parts of an insurance policy for complex claims

 

Ability to follow reserving process for indemnity and expense in analyzing the potential exposure of complex claims

 

Ability to determine the scope and exposure for complex claims

 

Ability to leverage trend and relationships to provide high-quality customer service

 

Well-versed in identifying, understanding and explaining complex financial and/or actuarial trends/concepts

 

Ability to effectively communicate coverage determinations to customers/clients/brokers for complex claims

 

Ability to direct counsel on an ongoing basis to guide the course of complex litigation and settlement strategies

 

 

As a condition of employment at Zurich, employees must adhere to our COVID-related health and safety protocols (https://www.zurichna.com/careers/faq), including, without limitation, a requirement that employees attest as to their vaccination status with a YES/NO, and upload proof of vaccination status, or negative COVID test results when allowable, to a third-party vendor. These are continuously re-evaluated and the requirements may change at any time.

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