Agency Claims Consultant
About The Position
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
Requirements
- 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.
- Associate in Claims (AIC) certification.
- Associate in Risk Management (ARM) certification.
- 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.
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.
Benefits
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
11-50 employees
