Workers Compensation - Sr Consultant Casualty Claims - Southwest

About the role

The Sr Consultant Casualty Claims is responsible for managing moderate to complex and high-value casualty claims with minimal supervision. This role requires advanced investigative and negotiation skills to effectively resolve disputes and handle escalated situations. The Consultant works closely with internal and external experts, including legal counsel and technical specialists, to ensure thorough claim evaluation and resolution.

Responsibilities

• Independently manage moderate to complex, high-value casualty claims, ensuring thorough analysis and resolution.
• Lead thorough investigations, assess coverage, and issue appropriate documentation including reservation of rights and coverage letters.
• Escalate issues as needed.
• 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.
• Ensure all claims activities comply with regulatory and company standards.
• Maintain accurate, detailed records and prepare comprehensive reports.
• Execute jurisdictional compliance requirements and support others in understanding regulatory obligations.
• Serve as a mentor to junior claim handlers, providing guidance on complex claims, compliance, and litigation processes.
• Support training initiatives and contribute to the development of best practices and educational materials.
• Deliver empathetic, clear communication throughout the claims process.
• Educate claimants and stakeholders, affirm next steps, and ensure a positive customer experience.
• Attend industry events and continuing education seminars to stay current with best practices, legal developments, and emerging trends.

Requirements

• Bachelor’s degree preferred, or a combination of education and equivalent experience.
• Typically requires 5–10 years of claims handling experience.
• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.
• 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 both verbal and written formats across a variety of situations.
• Selects appropriate communication channels and consistently demonstrates empathy toward all stakeholders.
• 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.
• Makes informed decisions based on thorough analysis of complex issues.
• Evaluates risks and outcomes, acts independently within authority, and identifies patterns in claims to support resolution strategies.
• Skilled in investigating complex cases and collaborating with internal and external experts.
• Cooks closely with legal, underwriting, and other stakeholders to ensure thorough evaluation.
• Possesses in-depth understanding of the regulatory environment and jurisdictional requirements.
• Handles complex compliance issues and mentors others on regulatory standards.
• Provides exceptional, empathetic customer service.
• Effectively manages escalated claims and sensitive customer concerns with professionalism and clarity.
• Able to use a personal computer and other standard office equipment.
• Able to sit and/or stand for extended periods.
• Required to work on-site as needed.
• Able to travel as necessary.
• Able to work in a fast-paced, changing or stressful environment.
• Able to perform work in a noisy/loud work environment.
• May be required to have and maintain sufficient home-based internet connection.

Qualifications

• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.
• 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 both verbal and written formats across a variety of situations.
• Selects appropriate communication channels and consistently demonstrates empathy toward all stakeholders.
• 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.
• Makes informed decisions based on thorough analysis of complex issues.
• Evaluates risks and outcomes, acts independently within authority, and identifies patterns in claims to support resolution strategies.
• Skilled in investigating complex cases and collaborating with internal and external experts.
• Cooks closely with legal, underwriting, and other stakeholders to ensure thorough evaluation.
• Possesses in-depth understanding of the regulatory environment and jurisdictional requirements.
• Handles complex compliance issues and mentors others on regulatory standards.
• Provides exceptional, empathetic customer service.
• Effectively manages escalated claims and sensitive customer concerns with professionalism and clarity.

Skills

• Advanced investigative and negotiation skills.
• Sound judgment and decision-making on high-exposure cases, including litigation and compliance matters.
• Clear and effective communication in both verbal and written formats.
• Comprehensive and organized claim records and reports.
• Thorough analysis of complex issues.
• Evaluation of risks and outcomes.
• Independent problem-solving and decision-making.
• Collaboration with internal and external experts.
• Handling complex compliance issues.
• Exceptional, empathetic customer service.

Benefits

• Medical, dental, vision, life, and disability insurance.
• 401K with a company match.
• Tuition reimbursement.
• PTO.
• Flexible work arrangements.
• Cultural Awareness Day in support of IDEOn-site medical/wellness center (Worcester only).
• Continuing education seminars.

Pay

The target hiring range for this role may vary based on geographic location and other factors, including merit or performance, demonstrated proficiency, skills for the role, education, travel requirements, and experience. Additional compensation may include an annual bonus (which could take the form of a general bonus, sales incentive, or short-term incentive), long-term incentive or spot recognition awards. The posted range reflects our ability to hire at different position titles and levels depending on background and experience.

Schedule

This is a remote Full-time/Exempt role.