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3 days
Not Specified
Not Specified
$26.43/hr - $38.61/hr (Estimated)
<p>Our Workers Comp Level One Claims department is seeking a Casualty Claims Consultant. This is a remote Full-time/Exempt role with field investigations.</p> <p>POSITION OVERVIEW: The Consultant Casualty Claims is responsible for managing a caseload of moderate complexity claims from start to finish. This includes conducting thorough investigations, assessing liability, negotiating settlements within defined authority limits, and maintaining clear communication with claimants, third parties, and legal representatives. The role requires strong analytical skills, sound judgment, and adherence to company policies and regulatory standards throughout the claims process.</p> <p>IN THIS ROLE, YOU WILL:</p> <p>Manage a caseload of moderately complex casualty claims from intake through resolution. Conduct thorough investigations, assess liability, and evaluate damages using established procedures. Collaborate with underwriting, legal, and internal/external stakeholders as needed to ensure comprehensive claim evaluation. Identify and refer potentially suspicious claims to the Special Investigations Unit. Apply comparative negligence laws and state-specific regulations to claim assessments. Set reserves, authorize payments, and demonstrate financial acumen within scope of authority. Utilize technology and data tools to enhance claims processing efficiency and accuracy. Communicate directly with claimants, legal representatives, and third parties to negotiate fair resolutions. Maintain detailed and compliant documentation of claim activities and communications. Participate in team collaboration, problem-solving discussions, and cross-functional coordination. Support subrogation efforts and risk transfer opportunities to benefit insureds and business partners. Handle sensitive communications professionally and translate complex information for diverse audiences. Mentor entry-level claim handlers and share best practices learned through training and experience. Attend ongoing training and education to maintain licensing and stay current on industry standards. Independently manage indemnity, medical, and basic arbitration or mediation components of claims with supervisory support.</p> <p>WHAT YOU NEED TO APPLY:</p> <p>Associate degree required; bachelor's degree preferred or combination of education and experience. Typically has 1-4 years of relevant claims handling experience. Must possess or obtain and maintain appropriate state adjuster licenses. Conduct independent analysis of contractual indemnification. Independently execute indemnity, medical, litigation/resolution management. Proficient with basic computer navigation; ability to use basic software systems/applications (Suite of MS Office Products) and use of internet. Learn and handle negotiations independently within authority, understand common tactics for moderately complex claim resolution. Use judgement and effectively utilize the most suitable communication channel while displaying empathy towards all stakeholders. Knowledge of various types of insurance products and processes. Conduct thorough investigations; identify key issues and gather evidence. Provide effective empathetic customer service; handle routine inquiries and issues. Ability to use a personal computer and other standard office equipment. Able to use all Microsoft office products Ability to sit and/or stand for extended periods. Required to work on-site as needed. Ability to travel as necessary. Ability to work in a fast paced, changing or stressful environment. Ability to perform work in a noisy/loud work environment. May be required to have and maintain sufficient home-based internet connection.</p> <p>This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.</p>
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