Work Comp TPA Oversight Claims Consultant

CNA Insurance • Downers Grove, IL

22h • Hybrid

About The Position

This individual contributor position works under general direction, and within broad authority limits, to provide technical oversight of complex, high-exposure commercial Workers’ Compensation claims handled by Third-Party Administrators (TPAs). While not responsible for people management, the role functions as a subject matter leader, influencing claim outcomes through expertise, collaboration, and oversight. The position is responsible for reviewing and guiding claim strategies, reserves, and resolution plans to ensure alignment with company protocols, regulatory requirements, and best practices. Success in this role requires the ability to lead through influence by setting expectations, partnering effectively with TPAs, clients, and internal stakeholders, and driving accountability for quality, compliance, and performance through consultative engagement and clear communication. The role may support designated accounts and requires regular interaction with internal and external partners to achieve optimal claim outcomes and customer service standards.

Requirements

• Advanced technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
• Strong communication, negotiation and presentation skills.
• Ability to effectively interact with all levels of CNA's internal and external business partners.
• Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.
• Ability to deal with ambiguous situations and issues.
• Creativity in resolving unique and challenging business problems.
• Knowledge of Microsoft Office Suite and other business-related software.
• Ability to adapt to change and value diverse opinions and ideas.
• Ability to manage and prioritize multiple projects.
• Ability to evaluate claims based on a cost benefit analysis.
• Ability to fully comprehend complex claim facts and issues; and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
• Ability to implement strategies with a proactive long-term view of business goals and objectives.
• Bachelor's degree or equivalent experience.
• Typically a minimum eight years claims experience.

Nice To Haves

• Professional designation preferred.

Responsibilities

• Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages.
• Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy accordingly.
• Effectively manages loss costs and claim expenses.
• Manages all types of investigative activity or litigation on major claims, including the posting of appropriate reserves in a timely manner.
• Coordinates discovery and litigation strategy with staff counsel or panel attorneys.
• Negotiates highly complex settlement packages, and authorizes payment within scope of authority, settling claims in most cost effective manner and ensuring timely issuance of disbursements.
• Coordinates third party recovery with subrogation/salvage unit.
• Makes recommendations on claims processes and resolution strategies to management.
• Analyzes claims activities; prepares and presents reports to management and other internal business partners and clients.
• Works with attorneys, account representatives, agents, doctors and insureds regarding the handling and/or disposition of highly complex claims.
• Keeps current on state/territory regulations and issues, industry activity and trends.
• May participate in industry trade groups.
• Provides guidance and assistance to less experienced claims staff and other functional areas.
• Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.

Benefits

• CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Number of Employees: 1,001-5,000 employees