Account Consultant

This is a fully remote position, open to applicants in Florida.

📋 Description

• Oversee a caseload of claims ranging from basic to highly complex within authorized limits, including financial implications.

• Gather customer information and adhere to specific account instructions.

• Coordinate specialized services such as subrogation, fraud assessment, and review of case management.

• Build and sustain effective relationships with both internal and external customers and colleagues.

• Guide and mentor Account Representatives and Account Specialists.

• Lead round table discussions within the designated team.

• Investigate, assess, and resolve claims effectively.

• Identify potential issues and trends in claim files, taking corrective action or making recommendations accordingly.

• Interpret medical reports, state laws, and jurisdictional regulations in the management of claims.

• Evaluate indemnity, medical, and expense exposure and apply insurance coverage appropriately.

• Review client files and collaborate with the team on strategic approaches, claim statuses, and emerging trends.

• Actively manage litigation with clients and legal representatives.

• Reduce financial liability while ensuring compliance and achieving favorable outcomes.

• Compile necessary documentation to avert penalties and fines.

• Accurately issue state-mandated documentation within jurisdictional deadlines.

• Monitor reports to ensure compliance with jurisdictional requirements, including EDI and timely benefit payments.

• Assist the Team Lead in tracking team assignments and projects.

• Review and submit SAS/SOX documentation punctually.

• Support takeover and reverse takeover initiatives.

• Perform additional assigned responsibilities and aid in quality programs.

⛳️ Requirements

• State adjuster licenses are mandatory.

• A minimum of six (6) years of relevant experience and/or training, or a comparable combination of education and experience is required.

• Comprehensive legal and jurisdictional understanding based on the specific line of business.

• Excellent oral and written communication skills, including proficiency in presentations.

• Proficient in PC usage, including Microsoft Office applications.

• Strong analytical and interpretive abilities.

• Exceptional organizational skills.

• Outstanding interpersonal abilities.

• Strong customer service orientation.

• Capability to work collaboratively in a team setting.

• Ability to meet or surpass Performance Competencies.

• A bachelor's degree from an accredited institution is preferred.

• Ability to manage multiple priorities and adhere to deadlines.

• Willingness to travel as necessary.

🏝️ Benefits

• Commitment to work-life balance.

• Supportive and caring work culture.

• Reasonable accommodations provided when applicable and appropriate.

• Equal Opportunity Employer.

• Maintains a Drug-Free Workplace.