Claims Consultant

Job Summary

Seeking a highly skilled and experienced Claims Consultant to serve as a vital liaison between Producers and insured clients. The ideal candidate will play a key role in resolving complex claims issues, providing expert guidance, and ensuring smooth communication between all stakeholders. This position requires a professional with a strong background in claims management, excellent communication skills, and the ability to think analytically in challenging situations.

Compensation Package

• Competitive salary commensurate with experience
• Comprehensive benefits package, including health, dental, and vision insurance
• Paid time off and holidays
• Opportunities for professional development and certification reimbursement

Responsibilities

• Review and obtain status updates on loss runs during account renewals or as needed.
• Attend prospective customer sales presentations to highlight the value-added services of the claims department.
• Investigate individual claims identified by Producers or accounts, ensuring appropriate handling and reserving value.
• Propose alternative methods for resolving claims, assist insured clients with Return-to-Work plans, and identify suitable treatment specialists or resources.
• Provide technical guidance on claims procedures and coverage to Producers, Customer Service Representatives (CSRs), and insured clients.
• Conduct claims review meetings with insured clients, Producers, and claim representatives.
• Deliver onsite training for insured clients on claims reporting procedures, returning injured workers to the job, and mitigating Employment Practices Liability exposures.
• Advocate for insured clients in coverage disputes with insurance companies and assist in analyzing coverage issues.
• Organize technical presentations for Producers, CSRs, and customers on claims-related topics.
• Evaluate injury types, accident trends, location patterns, and communication barriers to improve claims outcomes.
• Establish and maintain a preferred medical treatment network for workers’ compensation injuries.
• Foster strong communication links with various insurance claims departments.
• Perform other duties as assigned.

Qualifications/Requirements

Education/Experience

• Bachelor’s degree required.
• Minimum of 15 years of experience in claims management, including roles as a Claim Representative, Claim Supervisor, and Claim Consultant.
• Multi-line claims background, including Workers’ Compensation, Liability, and Property.

Licensure/Certification

• Associate in Claims (AIC) certification.
• Associate in Risk Management (ARM) certification.

Personal Characteristics

• Exceptional communication skills with the ability to handle difficult situations and individuals effectively.
• Strong analytical thinking and problem-solving abilities.
• Proven ability to resolve disputes between Claim Representatives and insured clients.
• Reliable and punctual with a commitment to professional excellence.

#LI-CH3

Senior Claims Consultant

Compensation Package

• Base Salary: $90,000 – $110,000 annually (based on experience)
• Competitive benefits package, paid time off, professional development opportunities, etc.
• Must have P&C License
• At least 5 years of experience adjusting claims

Position Summary
Our National retail client is seeking a Senior Claims Consultant to oversee claims handling and client advocacy. This role requires independent judgment, strong technical expertise, and the ability to serve as a key liaison among clients, carriers, Account Executives, and Producers. Candidates must hold an active P&C (Property and Casualty) insurance license.

Key Responsibilities

• Oversee a portfolio of Commercial and, as applicable, Personal Lines claims
• Act as liaison between clients, carriers, and internal teams on claim-related issues
• Attend strategy meetings and renewal meetings with Producers and Account Executives
• Advocate for clients in interactions with carriers on claims matters
• Maintain strong relationships and communications with carriers and clients
• Prepare and present claim reviews and action plans to clients
• Review and process new claim reports and court decisions
• Provide claims support through research, expertise, and communication
• Participate in trainings and educational presentations on claims handling and coverage issues
• Provide guidance to Claims Administrators on submission of claims and applicable lines of business

Qualifications

• Bachelor’s degree preferred
• Minimum 5 years of insurance industry experience adjusting claims
• Holds an active P&C (Property and Casualty) insurance license
• Strong knowledge of insurance coverages, claims processes, and regulations
• Proficiency with Microsoft Office Suite and agency management software
• Excellent communication, strategic planning, and problem-solving skills
• Highly organized with ability to manage multiple priorities independently and in a team environment

#LI-JL1

Agency Claims Consultant

Job Summary

Seeking a dedicated and experienced Agency Claims Consultant to join a team. This role involves working directly with clients, carriers, and claims adjusters to guide clients through the claims process and proactively manage their claims. The ideal candidate will act as an advocate for clients, assisting with reporting, investigating, monitoring, and resolving insurance claims. This position offers the opportunity to work on a variety of insurance claims and collaborate closely with the Director of Claims.

Compensation Package

• Salary Range: $50,000 to $100,000 annually, based on experience.
• Benefits: Comprehensive benefits package, including a 401(k) plan.
• Work Arrangement: Hybrid schedule with three days in the office.

Responsibilities

• Serve as the primary point of contact for clients, carriers, and claims adjusters.
• Guide clients through the claims process, ensuring a seamless and efficient experience.
• Act as an advocate for clients by reporting, investigating, monitoring, and resolving insurance claims.
• Manage a variety of insurance claims independently and under the direction of the Director of Claims.
• Maintain accurate and up-to-date records of claims in the agency management system.

Qualifications/Requirements

• Education and Licensing: Property & Casualty (P&C) license preferred.
• Experience: Minimum of 2 years of experience in a similar role.
• Technical Skills: Proficiency in AMS360 software is required; familiarity with Epic is a plus.
• Soft Skills: Strong communication, problem-solving, organizational, and interpersonal skills. Ability to work independently and collaboratively in a team environment.

#LI-MB6

Commercial Lines Claims Processor

Job Summary

Seeking a dedicated and detail-oriented Commercial Lines Claims Processor to join a team. This role is integral to operations, providing exceptional service to clients and ensuring the efficient processing of claims and related transactions. The ideal candidate will have experience working with a variety of accounts, possess strong organizational skills, and demonstrate a professional and accountable work ethic. This position offers an excellent opportunity for growth within a supportive and collaborative environment.

Compensation Package

• Salary: $60,000 - $65,000 annually (depending on experience)
• Competitive benefits package, 401(k), paid time off, professional development opportunities, etc.

Responsibilities

• Process endorsements, certificates, change confirmations, and invoice all transactions as per instructions from Account Managers or Account Executives.
• Assist in processing new and renewal business as requested.
• Invoice assigned commercial premium transactions.
• Process confirmed cancellations.
• Provide prompt, courteous, and knowledgeable service to customers.

Qualifications/Requirements

• Licenses/Designations: Property & Casualty (P&C) license required.
• Experience: Minimum of 3 years of experience in a similar role, with exposure to a variety of accounts.
• Software Proficiency: Experience with Applied EPIC software is preferred.
• Soft Skills:
  • Professional demeanor.
  • Strong sense of accountability.
  • Ability to work independently and take initiative.
  • Team-oriented mindset.
  • Excellent communication and organizational skills.

#LI-BC2