Workers Compensation Claims Specialist II

Zurich Insurance

. Handle multi-party commercial line Workers' Compensation claims of moderate to high exposure and complexity within specific authority limits .

Posted 9/29/2026full-timeRemote • California • United StatesJuniorMid-Level💰 $65,900 - $108,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in handling multi-party commercial line Workers' Compensation claims, including case strategy development, coverage analysis, and effective negotiation of claim settlements. Proficient in managing complex claims while ensuring compliance with insurance regulations and best practices.

Highest-signal resume keywords

Workers' Compensation Claims ManagementClaims Documentation and Data AnalysisCoverage Analysis and Compensability DeterminationNegotiation and Settlement StrategiesAdjuster License Maintenance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementCoverage AnalysisCompensability DeterminationReserve ManagementClaims DocumentationRisk Transfer AnalysisLitigated Claims ManagementClaims Transfers and TransitionsAnalytical SkillsProblem-Solving Skills

Soft Skills

Verbal CommunicationWritten CommunicationCollaborationRelationship BuildingCritical Thinking

Tools & Technologies

Microsoft Office

Certifications & Qualifications

Adjuster LicenseCalifornia Self-Insured License

Industry Keywords

Insurance RegulationsOwner-Controlled Insurance ProgramsWrap-Up ProgramsCommercial ClaimsCalifornia Jurisdiction

About the role

Key responsibilities & impact

Handle multi-party commercial line Workers' Compensation claims of moderate to high exposure and complexity within specific authority limits
Document claims files accurately by capturing and updating claims data and information in compliance with best practices
Determine compensability by gathering and analyzing relevant facts, applying applicable law, and establishing basic principles of negligence
Determine policy verification and coverage by analyzing applicable coverage and whether the loss falls within coverage
Develop case strategy and case evaluations, escalate issues as appropriate, and work toward timely claim resolution
Establish timely reserves and conduct ongoing reviews throughout the claims cycle within authority limits
Assess damages by calculating applicable damages or ranges allowed by law
Negotiate claim settlements using appropriate strategies, tools, and resources within authority limits
Meet quality standards by following best practices
Deliver customer-centric claims service

Requirements

What you’ll need

Bachelor degree and 3 or more years of experience in the Claims or Insurance area; OR Zurich Certified Insurance Apprentice, including an associate degree with 3 or more years of experience; OR completion of Zurich Claims Training Program and 2 or more years of experience; OR high school diploma equivalent and 5 or more years of experience
Must obtain and maintain required adjuster license(s)
Microsoft Office experience
Knowledge of insurance regulations, markets and products
Valid California Self-Insured (SIL) License preferred
5+ years of experience handling high-exposure Workers' Compensation claims involving complex medical, legal, and indemnity issues preferred
California jurisdictional experience preferred
Experience handling commercial claims for a major insurance carrier preferred
Experience managing litigated claims, including directing defense counsel, developing litigation strategy, participating in mediations and settlement conferences, and maintaining appropriate indemnity, medical, and expense reserves preferred
Experience handling claims transfers and transitions preferred
Knowledge of Owner-Controlled Insurance Programs (OCIPs), Wrap-Up programs, and construction-related claim handling preferred
Strong understanding of coverage analysis, compensability determinations, reserve management, and risk transfer opportunities, including contractual liability and third-party recovery preferred
Exceptional verbal and written communication skills preferred
Strong analytical, critical thinking, and problem-solving skills preferred
Ability to manage multiple priorities, collaborate cross-functionally, and build effective working relationships preferred
No employment sponsorship offered

Benefits

Comp & perks

Short-term incentive bonus eligibility set at 10%
Competitive pay
Comprehensive benefits for employees and their families
Growth opportunities
Inclusive and supportive work environment