Strategic Claims Consultant

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

We are seeking a seasoned claims professional to join our team as a Strategic Claims Consultant. This role is ideal for someone with a background in claims examination, account management, or TPA oversight who thrives in a client-facing, strategic environment. The successful candidate will provide high-level claims advocacy, program analysis, and risk services to clients, working closely with Senior Claims Leaders and Placement Teams. This role does not currently include direct reports but requires leadership in strategy, workflow enhancement, and analytics-driven decision-making. Responsibilities include but are not limited to:

• Serve as a strategic partner to clients, guiding them through the claims process with proactive consultation and advocacy.
• Oversee and collaborate with TPAs to ensure timely, fair, and efficient claims resolution.
• Develop and implement claims service plans tailored to client needs and risk profiles.
• Utilize analytics tools to identify claims trends and recommend targeted review strategies.
• Advise clients on emergency response, documentation, and vendor selection (e.g., restoration firms, engineers).
• Advocate for early and partial payments to support client cash flow.
• Provide expert guidance on coverage positions and negotiate on behalf of clients when adverse determinations arise.
• Collaborate with internal teams to share insights, identify coverage concerns, and support placement strategies.
• Contribute to new business development efforts, including RFP responses and client presentations.
• Mentor junior team members and promote best practices across the claims advocacy function.
• Maintain strong relationships with clients, adjusters, and vendors.
• Stay current on industry trends, regulatory changes, and market developments.

Qualifications

Required:

• Bachelor's degree in Business, Risk Management, or related field, or equivalent experience (8-10+ years in insurance/claims).
• Prior experience in a TPA, brokerage, or carrier claims role with strategic oversight responsibilities.
• Ability to obtain and maintain appropriate state broker licenses.
• Strategic thinker with strong critical judgment, initiative, and a track record of driving innovation and process improvement.
• Exceptional interpersonal and communication skills, with the ability to collaborate effectively in team environments and influence stakeholders.
• Proven ability to lead client and market discussions, align cross-functional teams, and deliver measurable results.
• Experience working in a data-informed environment, with the ability to quantify and assess the impact of claims advocacy and program strategies.
• Familiarity with claims program performance analytics or actuarial principles is a plus.
• Excellent time management and organizational skills, with the ability to work independently and manage multiple priorities.
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint); experience with claims analytics tools is a plus.

Preferred:

• Experience with workflow optimization and process improvement.
• Familiarity with claims data platforms and reporting tools.
• Demonstrated success in mentoring or coaching peers.

Teammate Benefits & Total Well-Being

We go beyond standard benefits, focusing on the total well-being of our teammates, including:

• Health Benefits : Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
• Financial Benefits : ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
• Mental Health & Wellness : Free Mental Health & Enhanced Advocacy Services
• Beyond Benefits : Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.

The Power To Be Yourself

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, "The Power to Be Yourself".