OverviewThe Claims Consultant is a client-facing technical advisor responsible for complex commercial Property & Casualty claims, excluding Workers' Compensation. The role provides claim strategy, coverage consultation, client advocacy, carrier accountability, and executive-level guidance while partnering with clients, carriers, legal counsel, Producers, Account Executives, Risk Management Consultants, and other stakeholders.
Primary Lines of Coverage Commercial Property, General Liability, Commercial Auto, Inland Marine, Builders Risk, Professional Liability, Employment Practices Liability, Management Liability, Cyber, Crime and Fidelity, Umbrella and Excess, and other specialty P&C coverages.
Essential Duties and Responsibilities:Complex Claims Strategy and Advocacy- Lead high-severity, complex, litigated, sensitive, or coverage-challenged claims and develop clear action plans, ownership, and resolution objectives.
- Review liability, financial exposure, reserves, settlement posture, litigation developments, and carrier handling.
- Analyze policy language, endorsements, exclusions, reservations of rights, coverage positions, and denials; advocate for appropriate carrier review and escalation.
- Coordinate with carriers, TPAs, counsel, experts, vendors, and internal leadership while maintaining clear boundaries between consultation, carrier authority, and legal advice.
- Identify subrogation, risk-transfer, tender, indemnification, and recovery opportunities when applicable.
Client Consultation and Carrier Accountability- Serve as the claims advisor for assigned clients and lead large-loss reviews, stewardship and service plan discussions, and executive claim presentations.
- Provide proactive, practical updates that explain significant developments, business implications, client actions, and next steps.
- Evaluate carrier and TPA performance, address delays or service concerns, and escalate unresolved issues to appropriate leadership.
- Contribute claims insight to renewal, placement, retention, and carrier-selection discussions.
Claims Analytics and Team Leadership- Review loss runs, reserves, claim duration, severity, closure activity, and recurring loss drivers; translate findings into practical recommendations.
- Partner with Risk Management Consultants to connect claim trends with loss-prevention and risk-mitigation opportunities.
- Partner with Producers, account service teams, and other stakeholders to support client needs, new business, retention, and effective handoffs.
- Contribute to service standards, escalation procedures, training, and continuous process improvement.
Documentation and Compliance- Maintain accurate and timely claim documentation, diary dates, communications, advice, and next steps in Applied Epic and other approved systems.
- Protect confidential information and follow privacy, cybersecurity, documentation, escalation, and E&O-risk-management requirements.
- Immediately escalate suspected reporting errors, missed deadlines, incorrect advice, or other potential E&O issues.
Qualifications- Five or more years of progressively responsible commercial P&C claims experience with a brokerage, carrier, TPA, independent adjusting firm, or comparable organization.
- Demonstrated experience with complex commercial claims, coverage issues, reserves, litigation, settlement considerations, and carrier escalation.
- Strong knowledge of commercial Property, General Liability, Auto Liability, and related P&C coverage forms and claim processes.
- Strong judgment, analytical ability, negotiation, writing, presentation, and relationship-management skills.
- Ability to communicate confidently with clients, carriers, adjusters, legal counsel, Producers, and leaders.
- Experience with Applied Epic or another agency or claims-management system preferred; proficiency with Microsoft 365 required.
Preferred Qualifications:- Associate or bachelor's degree in insurance, risk management, business, finance, or a related discipline.
- AIC, ARM, CPCU, or comparable insurance designation.
- Property & Casualty producer and/or claims-adjuster licensing, based on role and jurisdiction.
- Experience supporting large or multi-location commercial clients and facilitating claim reviews, stewardship meetings, analytics, and executive presentations.
Core Competencies- Strategic claims judgment
- Client advocacy
- Coverage analysis
- Negotiation and influence
- Carrier accountability
- Executive communication
- Analytical thinking
- Technical leadership
- Documentation discipline
- Cross-functional collaboration
Measures of Success- Complex claims receive timely strategic oversight, clear ownership, and effective escalation.
- Clients receive proactive, understandable, and decision-useful guidance.
- Claim reviews and stewardship discussions produce documented recommendations and follow-up actions.
- Consulting time remains focused on complex advocacy, analysis, strategy, and client-facing work.
- Claim files are accurate, timely, complete, and support retention, risk mitigation, and client strategy.
Other Job InformationCompensation: Commensurate with experience plus potential for annual merit increase. In addition to your competitive salary, you will be rewarded benefits including: 11 paid holidays, paid vacation, Medical, Vision & Dental insurance, 401K with generous match, Pension, Tuition Reimbursement, Banking discounts and the list goes on!
Physical Requirements:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee may be required to stand, walk or sit. Use hands and fingers, handle or feel, reach with hands or arms, and speak and hear. The employee may occasionally be required to lift and or move up to 25 pounds. Specific vision abilities required by this job include close vision, and the ability to focus.
MinimumUSD $66,000.00/Yr.
MaximumUSD $108,804.00/Yr.
