Senior Claims Consultant
6 days ago
My client is looking to add a Senior Claims Examiner to deliver exceptional claim advocacy and oversight for Tier 1, 2, and 3 clients across property, casualty, and workers' compensation losses. This role ensures accurate and timely claim settlements, conducts legal reviews and investigations, and provides leadership and problem resolution for clients and carrier adjusters. You will also monitor claim files to maintain high standards of quality and service.
Essential Functions
- Collaborate with the Claims Manager to develop performance and service standards, and assist in implementing and monitoring claims management plans.
- Prepare management reports to track performance and outcomes.
- Mentor junior claims professionals and participate in ongoing training under the Director of Risk Management Services.
- Review claim documentation for coverage accuracy and maintain updates in EPIC.
- Handle complex inquiries from insureds, third-party claimants, and colleagues, ensuring timely and effective resolutions.
- Prepare detailed loss summaries and assist in creating specialized claims service plans for VIP clients.
- Analyze loss details, financial impacts, and reserve trends, including workers' compensation reserve analysis.
- Stay current on legislative and regulatory changes impacting claims advocacy and educate clients and colleagues accordingly.
- Conduct field inspections, client claim reviews, and liaise between clients and carriers to resolve issues and establish special handling instructions.
- Support producers with claims enrolled in workers' compensation programs, including reviewing NCCI Worksheets and Mod-Master reports.
- Maintain agency claims logs, large loss reports, and litigated claims reports.
- Deliver claims training seminars and participate in professional development to maintain licenses and certifications.
- 10+ years of experience in casualty claims
- Bachelor's degree in business, accounting, or marketing preferred.
- Professional insurance-related designations highly desirable.
- Ability to obtain required state insurance licenses and adjuster's license within one year.
- Strong analytical, negotiation, and problem-solving skills.
- Proficiency in Microsoft Office and agency management systems.
- Excellent communication and interpersonal skills with the ability to work in a fast-paced environment.
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