Claims Consultant - Business Insurance

Marsh McLennan•Schaumburg, IL

9d•Hybrid

About The Position

As a Claims Consultant, you will be responsible for providing exceptional customer service and collaborating with various stakeholders to ensure timely and accurate claims processing. This role focuses exclusively on Work Comp claims, handling an expected caseload of 200 files across 16–20 states, with a mix of Med Only and Indemnity claims. You will analyze compensability on new claims, review reserve changes from monthly loss-run uploads, and evaluate settlement reserves. The role involves driving claim strategy by pushing carrier adjusters for IMEs, surveillance, timely treatment, and following up on doctor appointments to push for RTW/MMI. You will also coordinate with adjusters, defense counsel, and clients to gather litigation information, build defenses, negotiate settlements, and provide timely updates. Maintaining accurate diaries and detailed notes within the Trideo platform, participating in claim reviews and conference calls, and providing critical investigation and loss-control support for the insured are key responsibilities. This includes coordinating testing, medical canvas, and reviewing reserve requests for appropriateness, requesting reductions when necessary.

Requirements

Work exclusively on Work Comp claims, handling an expected caseload of 200 files across 16–20 states (mix of Med Only and Indemnity)
Analyze compensability on new claims and review reserve changes from monthly loss-run uploads, including settlement evaluation reserves
Drive claim strategy by pushing carrier adjusters for IMEs, surveillance, timely treatment, and by following up on doctor appointments to push for RTW/MMI
Coordinate with adjusters, defense counsel, and clients to gather litigation information, build defenses, negotiate settlements and special handling instructions, and provide timely updates
Maintain up-to-date, accurate diaries and detailed notes within the Trideo platform and participate in claim reviews and conference calls
Provide critical investigation and loss-control support for the insured (e.g., coordinating testing, medical canvas) and review reserve requests for appropriateness, requesting reductions when necessary

Nice To Haves

5+ years of experience in claims handling within an agency or insurance carrier
BS/BA in Business, Insurance or related field
AIC, SCLA or other related professional designation
Advanced proficiency in Microsoft Office Suite

Responsibilities

Work exclusively on Work Comp claims, handling an expected caseload of 200 files across 16–20 states (mix of Med Only and Indemnity)
Analyze compensability on new claims and review reserve changes from monthly loss-run uploads, including settlement evaluation reserves
Drive claim strategy by pushing carrier adjusters for IMEs, surveillance, timely treatment, and by following up on doctor appointments to push for RTW/MMI
Coordinate with adjusters, defense counsel, and clients to gather litigation information, build defenses, negotiate settlements and special handling instructions, and provide timely updates
Maintain up-to-date, accurate diaries and detailed notes within the Trideo platform and participate in claim reviews and conference calls
Provide critical investigation and loss-control support for the insured (e.g., coordinating testing, medical canvas) and review reserve requests for appropriateness, requesting reductions when necessary

Benefits

Medical, dental, vision, 401K benefits
The flexibility to work at home or an office, based on your discretion and schedule
Start with 20 days of paid time off
A paid day off to volunteer and company-organized volunteer events
Up to $1,000 per year in matching charitable donations
Up to $750 per year in wellness rewards
All the nitro cold brew coffee and sparkling water you can drink
health and welfare benefits
tuition assistance
401K savings and other retirement programs
employee assistance programs