Workers Compensation Claims Consultant

Alera Group

$80K — $110K *
Finance & Insurance
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of experience in Workers' Compensation claims management
  • Proficient in complex loss analysis and WC claims litigation
  • Strong advocacy and mediation skills with clients, carrier, and TPAs
  • Registered Washington and/or Oregon Agent's License
  • Continued pursuit of professional insurance designations (e.g., INS, AIC, CPCU)
  • Excellent public speaking and presentation abilities
  • Attention to detail and effective task follow-through

Responsibilities

  • Build and maintain strong client relationships to enhance business retention
  • Provide claims oversight and technical expertise on WC issues
  • Coordinate and present claims reviews and risk analyses to clients
  • Research and advocate on coverage issues on behalf of clients
  • Function as an independent consultant for large reserves and settlements
  • Assist clients in developing return-to-work programs
  • Deliver training on claims management processes, such as 'WC 101'

Benefits

  • Comprehensive medical, dental, and life insurance
  • Disability insurance coverage
  • 401k retirement plan
  • Generous paid time off policy
  • Flexible working arrangements, including remote options
Full Job Description
RESPONSIBILITIES

Primary Role:

The WC Claims Consultant's role is to work effectively with our clients building solid relationships and retaining business. The WC Consultant works with all sales executives, internal staff in commercial lines departments, and externally with our clients, carriers and vendors. Service timeline focus is on larger valued or 360 Clients for onboarding new accounts and establishing claims services with their carrier/TPA/applicable vendors, providing claims oversight, employer training, and scheduling claim reviews and various presentations.

Duties also include providing claims service for all clients providing technical expertise and servicing as an advocate on client WC claim issues. WC Claims Consultants work independently with clients and their carrier/TPA consulting on large reserves, coverage issues, return to work issues, settlements, and other items that have a significant impact on retention and premiums. They may also present to prospects and clients at renewals, stewardship meetings and claim reviews.

QUALIFICATIONS

  • Contact with clients, carrier and TPA claims adjusters, internal customers, and vendors on regular basis to serve as advocate, liaison, mediator, resource & problem solver
  • Prepare, coordinate & present claim reviews, risk analysis, status spreadsheets and other claim meetings as requested
  • When coverage issues arise, will research potential solutions through a review of client's policies and then advocate on client's behalf with carrier
  • Participate with or without sales executives in presentations to current clients, prospects, proposals, and RFP presentations
  • Documentation and diary maintenance on key claims in Sagitta and ImageRight
  • Function as back-up for other WC Claims Team members
  • Provide assistance to clients seeking to enhance their return-to-work programs and light duty return to work opportunities
  • Provide claims management training, "WC 101" to clients to educate them on the claims process.
  • Strong attention to detail, dependability, and ability to follow through on tasks.
  • Proficiency in Sagitta, ImageRight, claims functions, carrier websites, and MS Office (Word, Excel, Outlook, PowerPoint)
  • Excellent oral and written communication skills, including public speaking and presenting to groups.
  • Washington and/or Oregon Agent's License with at least 5 years of experience in commercial, personal multiline, and workers' compensation claims
  • Expertise in complex loss analysis and commitment to continued insurance education (e.g., INS, AIC, SCLA, CPCU, CCM)

ADDITIONAL INFORMATION
• Minimum 5 years claims experience related to Workers' Compensation
• Proficient in complex loss analysis
• Familiarity with and experience in WC claims litigation
• Continued pursuit of professional designations (e.g., INS, AIC, SCLA, CPCU, ARM)

**California and Oregon experience preferred**

Alera Group offers comprehensive benefits to our colleagues, including medical, dental, life and disability insurance, 401k, generous paid time off and much more.

Salary range is $80K to $110K per year.

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Location Type

Remote

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