Casualty Claims Consultant

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

📋 Description

• Serve as a primary expert in navigating intricate casualty claims to achieve favorable outcomes.

• Collaborate with claims teams and leadership to formulate strategies, offer guidance on significant cases, and guarantee consistent, top-tier claim management.

• Foster continuous improvement by examining trends, assisting with audits, and enhancing team performance through coaching and collaborative efforts.

• Act as a subject matter expert on casualty claims policies, insurance programs, and industry best practices.

• Work alongside leadership to shape claim strategies, including reserving, expenses, and litigation management.

• Provide guidance on reserves and settlements, as well as authority on high-exposure or complicated claims.

• Track reserve development trends and assess claim performance across designated teams.

• Function as an escalation point for complex claim issues, collaborating with Legal, Underwriting, and external vendors.

• Lead and engage in claim roundtables, committees, and case discussions to ensure strategic alignment.

• Oversee major and complex claim files to direct handling and confirm progress.

• Work with Compliance and QA to implement audit action plans and elevate claim handling quality.

• Utilize customer feedback insights to identify challenges and enhance the claims experience.

• Contribute to the staffing, hiring, training, and development of casualty claims professionals.

• Ensure adherence to claim handling standards, conduct file reviews, and promote continuous improvement.

⛳️ Requirements

• Bachelor's degree or equivalent relevant experience.

• A minimum of ten years of progressively responsible experience in casualty claims or related fields.

• Possession of all necessary state licenses as required.

• Preferred insurance designations include AIC, CIC, AIM, and CPCU.

• Extensive knowledge of the theory and practice associated with the casualty claims function.

• Strong analytical skills and a proven track record of sound judgment regarding casualty loss and coverage.

• Comprehensive understanding of insurance contracts, medical terminology, and the legal aspects of court procedures impacting legal liability across all insurance lines.

• Up-to-date knowledge of all insurance lines, relevant court rulings, guidelines in the claims function, and policy changes and modifications.

• Proficient in computer systems and claims management software.

• Willingness to travel occasionally; a valid driver's license with an acceptable motor vehicle report per company standards is required for driving.

🏝️ Benefits

• Exceptional benefits package including life, medical, dental, vision, and prescription drug coverage.

• Competitive paid time off plan along with a full day of volunteer time off each year.

• Financial incentives such as a 401(k) plan match, pension plan, OneEMC bonus plan, and recognition and anniversary awards.

• Opportunities for professional development and growth, including tuition reimbursement.

• Wellness initiatives aimed at enhancing team member well-being and lowering health insurance costs.

• Flexibility in dress code and opportunities for alternative work arrangements.