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.

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.

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.

Strategic Claims Consultant

Key skills