Claims Specialist I

  • Company:
    Zurich NA
  • Location:
  • Salary:
    negotiable / month
  • Job type:
  • Posted:
    18 hours ago
  • Category:

**Claims Specialist I**


**Claims Specialist I**

**Job Summary**

**Job Summary**

Investigate, assess, and bring Liability Commercial claims to resolution by adhering to the Best Practices. Handle claims efficiently and effectively while delivering customer-centric claims service. Ability to work independently with little guidance. Claims may involve litigation.

The job’s core deliverables rely on delivering service to external clients and/or customers. Typically involves building relationships and promoting the company.

**Job Qualifications**

Basic Qualifications:

* At least 1 year of experience in handling Commercial Liability Claims

* Previous Customer service experience

Preferred Qualifications:

+ Detail oriented

+ Very analytical

+ Strong negotiation skills

+ Strong verbal and written communication skills

+ Experience collaborating across various work groups

+ Strong organization skills and time management skills

+ Microsoft Office experience

**Job Accountabilities**

Key Accountabilities:

* Document claims file by accurately capturing and updating claims data/information in compliance with best practices for low to moderate exposure and complexity personal or commercial line claims.

* Exercise judgement to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.

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

* 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 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.

* Meet quality standards by following best practices.

* Ensure customer service by proactively communicating information; responding to inquiries; following customer protocols and may participating in customer marketing efforts.

* Manage expenses by working within vendor approved networks and managing scope of work assigned to outside contractors. Departs 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.

* Protect Zurichs 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.

* Business Travel, as required

* Extended Hours during Peak Periods, as required

* Pass Applicable Exam/Licensing, as required

* Regular Predictable Attendance

Additional Job Functions:

* May 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.

* May be dedicated to handle claims for specific accounts to ensure consistency in service and enhance customer knowledge.

**Business Accountabilities**

* Review assigned customer cases, prioritize case load and interpret established policies, applying discretion within authority limits in order to resolve customer issues.

* Anticipate, recognize and respond timely to inquiries regarding low to medium complexity and exposure commercial claims to contribute to customer satisfaction.

* Provide technical advice that enables a customer to solve a problem or improve business.

* Acquire and organize the relevant evidence and information to accurately assess the value of the claim.

* Collect data and document in establsihed system to facilitate decision-making.

* Adhere to local regulatory and governance requirements throughout the life of a claim to ensure decisions are made using the right standards.

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

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

* Provide feedback on business processes and systems to identify opportunities for improvement.

**Performance Management Accountabilities**

* Model behaviors that demonstrate commitment to corporate values.

* Provide input into performance management discussions of project team members.

* Educate team members and business partners on area of technical expertise.

* Provide guidance and support for team members.

* Take action to manage own personal development and encourage others to do the same.

Imagine working for a company that truly cares about their employees, customers, stakeholders, and communities they serve. Imagine working for a values-driven organization that has the ambition and desire to be the best global insurance provider in the world. Zurich is that place where 55,000 employees across approximately 200 countries and territories are all focused on helping people and helping companies protect what is truly most important to them. We are a values-driven organization that takes pride in the work that we do every day and we have the ambition to be the best global insurer in the world.

Zurich is committed to providing a diverse, inclusive and barrier-free environment resulting in an accessible organization for employees, customers, and other parties who interact with, or on behalf of, Zurich. We strive to achieve a workplace free of discrimination of all forms, including discrimination on the basis of physical or mental disability, or medical condition. If you are interested in a job opportunity, please advise if you require an accommodation, so we can work with you to provide a more accessible process.

**Primary Location:** Canada-Ontario-Toronto

**Travel** Yes, 5 % of the Time

**Job Posting** 01/14/21

**Unposting Date** Ongoing

**Req ID:** 210000BX

It is the Policy of Zurich in North America, as an equal opportunity employer, to attract and retain the best-qualified individuals available, without regard to race/ethnicity, color, religion, gender expression, genetic information, national origin, sex, gender identity, sexual orientation, marital status, age, disability or protected veteran status.