Workers Compensation Claim Consultant

Responsibilities

• Serve as a trusted claims advisor, partnering with clients to develop and execute proactive claims management strategies aligned to their risk profile and business objectives.
• Analyze claims trends, loss data, and reserve development to identify emerging risks and recommend cost-containment strategies before further escalation occurs.
• Lead consultative claim reviews with clients, providing insight-driven recommendations, benchmarking data, and strategic action plans.
• Collaborate with carriers and TPAs to influence claim outcomes, including reserving strategy, settlement approach, and closure timelines.
• Proactively monitor key performance indicators (KPIs) such as reserve movement, closure rates, and experience modification factors, and advise clients on performance improvement opportunities.
• Evaluate claim handling processes and recommend enhancements to improve efficiency, and optimize claim lifecycle outcomes.
• Provide ongoing client education on claim best practices, regulatory considerations, and risk mitigation strategies, positioning OneGroup as a consultative partner rather than a transactional service provider.
• Support sales and retention efforts by articulating the value of proactive claims management and demonstrating measurable client impact.
• Facilitate development and implementation of targeted service plans that integrate claims strategy into overall risk management and client experience frameworks.
• Serve as a central point of coordination while driving accountability among stakeholders (clients, carriers, vendors) to ensure execution of agreed-upon strategies.
• Communicate with internal customers concerning client concerns and performance

Qualifications

Not Specified