Technical Consultant Casualty Claims- CGL

About the role

The Technical Claims Consultant, Casualty Claims, manages moderate to complex and high-value casualty and litigated claims with minimal supervision. This role requires advanced investigative and negotiation skills to resolve disputes and handle escalated situations, while collaborating with legal teams and subject matter experts as needed. The consultant analyzes complex data, provides expert opinions to support claim resolution, and may represent the company in litigation forums.

Responsibilities

• Independently investigate moderate to complex and sensitive claims, ensuring thorough analysis and resolution.
• Collaborate with internal and external experts to evaluate claims and determine validity and value.
• Identify opportunities to transfer risk and pursue subrogation.
• Proactively resolve disputes, deescalate sensitive situations, and ensure optimal claim outcomes through strategic negotiation and litigation management.
• Absorb and manage suspicious claims; refer to SIU as needed.
• Serve as a subject matter expert and contribute to departmental projects and initiatives.
• Draft coverage letters, including complex forms and endorsements; interpret commercial coverages and legal principles.
• Assess and transfer risk where appropriate; manage litigation budgets and counsel.
• Lead quality and efficiency initiatives for complex claims workflows.
• Use technology and data tools to identify trends, correct inconsistencies, and optimize outcomes.
• Negotiate high-value and contested claims using advanced strategies.
• Ensure compliance with jurisdictional requirements; mentor others on regulatory standards.
• Maintain accurate records and prepare detailed reports; protect PII and educate peers on best practices.
• Lead cross-functional meetings and drive consensus on claim resolutions.
• Communicate complex information clearly to diverse stakeholders; manage sensitive customer interactions.
• Provide technical guidance and mentorship to less experienced adjusters.
• Represent the company in litigation forums including trials, mediations, and arbitrations.
• Support training development and evaluate program effectiveness.
• Influence product development by identifying coverage gaps and recommending updates.
• Attend industry events and continuing education seminars to stay current with best practices, legal developments, and emerging trends.

Requirements

• Bachelor’s degree preferred or equivalent experience; typically 5+ years of industry experience; industry designation relevant to the role preferred.
• Recognized authority in negotiating highly complex claims; shapes and implements best practices.
• Skilled in negotiating complex claims and developing strategies to influence outcomes. Demonstrates sound judgment and decision-making on high-exposure cases, including litigation and compliance matters.
• Communicates clearly and effectively in verbal and written formats; handles sensitive and complex issues with professionalism.

Qualifications

• Selects appropriate communication channels and consistently demonstrates empathy.
• Maintains comprehensive and organized claim records and prepares detailed reports summarizing findings and recommendations.
• Highly organized with the ability to manage complex workflows and participate in project work. Demonstrates strong time management and desk management skills, and mentors others in these areas.
• Expert-level insurance knowledge; deep understanding of legal and regulatory frameworks.
• Makes informed decisions independently; analyzes risks and understands financial impacts.
• Exercises sound judgment and strategic insight in evaluating results and shaping policy.
• Designs empathetic customer service strategies; recognized for exceptional service.

Skills

• Analytical Reasoning.
• Customer Centricity.
• Digital Fluency.
• Persuasion and Influence.
• Professional Insurance Acumen.
• Planning and Execution.

Benefits

• Medical, dental, vision, life, and disability insurance.
• 401K with a company match.
• Tuition reimbursement.
• PTO.
• Company paid holidays.
• Flexible work arrangements.
• Cultural Awareness Day in support of IDEOn-site medical/wellness center (Worcester only).
• Click here for the full list of Benefits.