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Zenith Insurance Company (United States) · 1 day ago

Claims Specialist

East Norriton, PA

Full-time

Onsite

Mid Level

$77K/yr - $86K/yr

Zenith Insurance Company is a team of Workers' Compensation Specialists dedicated to helping businesses manage workplace injuries. The Claims Specialist role involves investigating claims, determining the company's liability, and negotiating settlements while maintaining positive relationships with stakeholders.

Financial ServicesInsurance

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

Qualification

Claims managementSettlement negotiationData analysisCommunication skillsTeam collaboration

Required

Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants

Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information

Calculate benefit payments and approve payment of Claims within a certain monetary limit

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

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

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

Zenith Insurance Company (United States)

Zenith is the premier specialist in workers’ compensation nationally, and a leader in property and casualty insurance for the California agriculture industry.

Founded in 1949