Senior Claims Consultant – IAS

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

📋 Description

• Act as the main consultant for workers' compensation claims for a specific portfolio of clients

• Represent clients with insurance carriers, third-party administrators, defense attorneys, and medical management vendors to achieve favorable claim results

• Perform reviews of claim files to pinpoint areas for reducing claim duration, enhancing reserve accuracy, and managing overall risk costs

• Oversee significant, catastrophic, and intricate workers' compensation claims

• Engage in claim strategy discussions and offer insights on return-to-work programs, litigation oversight, settlement prospects, and claim resolution

• Cultivate robust relationships with clients, becoming a trusted advisor on trends and best practices in workers' compensation claims

• Lead client claim review sessions and stewardship presentations

• Analyze claims data and generate executive-level reports and suggestions

• Aid in client retention and expansion initiatives through outstanding service and thought leadership

• Collaborate with producers, account executives, and service teams to foster new business and bolster existing client opportunities

• Examine loss trends, reserve practices, and claim results

• Spot emerging claim trends and risk exposures that affect client programs

• Partner with loss control to devise claim management strategies aimed at reducing expenses and enhancing program performance

• Keep abreast of current workers' compensation laws, regulations, and industry developments

• Offer technical guidance and mentoring to junior claims consultants and members of the service team

• Remain knowledgeable about carrier claim practices, medical cost containment strategies, and best practices in claim management

⛳️ Requirements

• Bachelor's degree or an equivalent mix of education and experience

• Over 7 years of experience in workers' compensation claims handling, consulting, brokerage claims advocacy, TPA management, or carrier claims

• In-depth expertise in California workers' compensation claims along with a solid understanding of multi-state workers' compensation programs

• Advanced knowledge of claims administration and litigation management in workers' compensation

• Experience in reviewing reserves, claim strategies, medical management programs, and complex claim exposures

• Excellent presentation, negotiation, and communication abilities

• Proficient in claims analytics and reporting tools

• Capacity to manage various priorities while delivering exceptional client service

• Background in working for an insurance brokerage, carrier, self-insured employer, or third-party administrator

• Preferred professional designations such as WCCA, WCCP, ARM, AIC, CPCU

• Experience in preparing and delivering executive-level stewardship presentations

• Familiarity with AI and related experience

• Willingness to travel may be necessary

🏝️ Benefits

• Comprehensive health and wellness programs

• Competitive salary and performance-based incentives

• Opportunities for professional development and growth

• Flexible work arrangements

• Support for continuing education and professional certifications