Strategic Claims Consultant

ConsultantConsultantFull TimeRemoteLeadTeam 10,001+Since 1939H1B No SponsorCompany SiteLinkedIn

Location

Florida

Posted

26 days ago

Salary

Not specified

Seniority

Lead

Bachelor Degree10 yrs expExperience acceptedEnglish

Job Description

• 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.

Job Requirements

  • 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.

Benefits

  • 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.

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