38 complex claims consultant jobs found

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  CNA is a market leader in insuring skilled nursing, assisted living and independent living facilities and this role will support the business and interact closely with internal business partners such as Underwriting, to share claim insights that aid in good underwriting decisions. Our Healthcare Claims team is seeking a Complex Claims Consultant to support our Aging Services segment. This individual contributor role is responsible for the overall investigation and management of Aging Services claims in multiple states. Recognized as a technical expert in the interpretation of complex or unusual policy coverages in area of expertise. Under general management direction, works within assigned...

Objective: The Claims Consultant is responsible for servicing and maintaining an assignment of consulting client contracts and for delivering agreed-upon services in compliance with Consulting Division workflows, policies, and procedures. The Claims Consultant will work closely with the client’s carriers and claims administrators to identify coverage for complex losses and ensure claims are managed proactively and reserved properly. The Claims Consultant will deliver timely Consulting Reports to their consulting clients and the corresponding Heffernan Account Management Team to document their efforts and results. This role requires workers' compensation experience and will be hybrid out of the Heffernan Los Angeles, CA office.    Responsibilities Include: Provide services according to the services sold to the individual client, meet timeline commitments, including but not limited to consulting reports, mod calculations and analysis, claim review(s), client...

ABOUT HUB: In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the worlds' largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters most will be protected-through unrelenting advocacy and tailored insurance solutions that put our clients in control. Our growing team of professionals across North America represents a broad, deep and one-of -a kind aggregation of entrepreneurs and leaders recognized for their excellence throughout the insurance community. THE OPPORTUNITY: The Personal Lines Account Executive manages an assigned book of business, develops client relationships and delivers to grow and retain clients. Possibly working alongside the Producer, the Account Executive is responsible for overseeing management of assigned accounts including redundant interface with appropriate decision makers, proactive consultation, insurance program design,...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description The Senior Consultant II – Fraud Analyst analyzes highly complex fraud patterns and the organization’s exposure to fraudulent claims, identifying patterns of suspected fraud and recommending appropriate cases for prosecution. The role leverages investigative data, analytical tools, and industry intelligence to identify emerging fraud risks and trends across multiple claims and entities. Once patterns are identified, the individual determines the appropriate course of action and oversees investigations and related litigation activities. National General is seeking a Senior Consultant II – Fraud...

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.   WHAT WE’RE LOOKING FOR The Personal Lines High Net Worth Claims Consultant serves as a trusted advisor to high‑net‑worth and ultra‑high‑net‑worth clients by providing white‑glove claims advocacy and end‑to‑end claims management. The individual in this role partners closely with clients, carriers, adjusters, and internal service teams to ensure timely resolution, exceptional service, and optimal claim outcomes across complex personal lines exposures. A GLIMPSE INTO YOUR DAY Serves as the primary...

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our  journey as we strive to transform the insurance  carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our  internal and external communities better everyday! Learn more...

This is a remote position based in the Sacramento or East Bay California with weekly field travel. Leads the development and management of strategic relationships with insurance agencies to drive profitable new business growth and ensure strong retention of existing accounts within an assigned territory. Evaluates, analyzes, and underwrites complex workers’ compensation risks—ranging from $75,000 to $500,000 in premium—exercising sound judgment within established authority levels. Serves as a primary liaison between agencies and internal partners. Contributes to the design and execution of the territory’s strategic agency plan, aligning agency performance with organizational goals. RESPONSIBILITIES/TASKS: Calculates, prepares and develops premium quotations using corporate underwriting guidelines within letter of authority. Determines underwriting eligibility for prospective policyholders and develops appropriate pricing for new business, renewals, and endorsements....

Overview Risk Control Consultant on the Strategic Risk Team (SRT) plays a key role in supporting underwriting, sales, claims, clients, agents, and brokers by providing expert guidance to key risk and agents/brokers. This position is responsible for tracking Risk Control service requests, handling inquiries, conducting service reviews, onboarding new accounts, and assisting large premium workers' compensation accounts with loss analysis and risk management services. The SRT Consultant will also engage in presenting to key agencies and regional underwriting offices and perform initial onsite Risk control visits to major clients. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization. This is a remote position. Responsibilities Inquiry Management: Answer questions and provide support through "Ask LC" and "LC Inquiry" for underwriting, sales, claims, clients,...

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Brown & Brown   is seeking a   Senior Associate Pharmacy & Clinical Services   to join our growing team in   San Diego, CA   or   Las Vegas, NV.     The Senior Associate Pharmacy & Clinical Services will   provide   strategic guidance on pharmacy benefits, clinical programs, and cost-management solutions,   leveraging   their PharmD   expertise   and industry knowledge. This role offers leadership growth opportunities, combining hands-on consulting with director-level responsibilities to drive impactful healthcare transformation for employers and employees.   How You Will Contribute:   Design and   optimize   pharmacy benefit strategies to align with organizational goals, cost containment, and employee satisfaction.   Provide clinical oversight on...

Job Description Job Description: Sales Enablement Manager Location: Hybrid/Costa Mesa, CA (United States) Reporting to: Head of Sales Enablement, North American Retail (NAR) About Acrisure A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more.  In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible. Job Summary: Acrisure is seeking a Sales Enablement Manager, to support the Head of Sales...

About the Role The Insurance GTM team is helping our customers and prospects solve critical problems within their Rating, Underwriting and Claims workflows.  Our Solutions Engineering team serves as the technical counterparts to the Account Executives.  Through this partnership, this role will help to understand a customer’s current challenges and desired outcomes through deep discovery and technical understanding.  The Pre-Sales Data Scientist will help insurance companies unlock the value of Nearmap's AI-driven data within their pricing, underwriting, modeling, and regulatory workflows through direct engagement with Nearmap customers as they scope, execute and analyze large scale data tests to measure this value.   This role’s key responsibility will be aligning customer data tests to the Nearmap suite of data and software products.  You will work closely with customers and prospects to develop success criteria, desired outcomes, and evaluation criteria, this role requires...

Company: Mercer Description: We are seeking a talented individual to join our Career Consulting team at Mercer. This role offers a hybrid work arrangement, requiring a minimum of three days per week in our Mercer offices or with clients. Mercer is uniquely qualified to help organizations design and execute sophisticated workforce strategies, whether it’s for a multinational organization or a local company attempting to grow within its market. We provide best-in-class consulting, rigorous analytics, and data-driven insights that help organizations make fact-based decisions.   As a Principal Executive Rewards Consultant, you will manage delivery of large-scale projects, coach team members, and solve complex compensation challenges. In addition, you will support the business development process. This is a great opportunity to partner with senior executives, Board members, and HR leaders to develop and deliver executive compensation strategies that attract, retain, and...

Company: Mercer Description: We are seeking a talented individual to join our Career Consulting team at Mercer. This role offers a hybrid work arrangement, requiring a minimum of three days per week in the office or with clients. Mercer is uniquely qualified to help organizations design and execute sophisticated workforce strategies, whether it’s for a multinational organization or a local company attempting to grow within its market. We provide best-in-class consulting, rigorous analytics, and data-driven insights that help organizations make fact-based decisions.   As a Principal consultant, you will lead delivery of large-scale projects, coach team members, and solve complex compensation challenges. In addition, you will support the business development process. This is a great opportunity to partner with senior management and HR leaders to develop and deliver compensation strategies that attract, retain, and motivate talent. What you will do: Structure,...

Foundation Risk Partners , one of the fastest growing insurance brokerage and consulting firms in the US, is adding an Commercial Lines Account Executive in the Small Business Unit to their  George Petersen Insurance Agency  team in Santa Rosa, CA Metro Region.  Job Summary: We’re looking for a dynamic professional to join our Small Business Unit (SBU) team in a role that blends account management with growth opportunities. Responsibilities include advanced communication skills, strong knowledge of insurance products, retaining an assigned book of business, as well as quoting and binding new policies for new and existing commercial lines accounts. Note: This position offers a significant opportunity to sell and develop new business, making it ideal for individuals who enjoy building relationships and driving revenue growth. Essential Functions: Review existing  commercial accounts  for  cross-selling opportunities and   gaps in coverage...

WHO WE ARE Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.   WHAT WE’RE LOOKING FOR The Senior Account Manager serves as the primary business contact for the client and is responsible for client satisfaction.  The person in this position is expected to consistently provide excellent customer service to assigned accounts, as well as represent client needs and goals within the organization to ensure quality.  In addition, the Senior Account Manager will build relationships with clients to encourage new and repeat business opportunities. A GLIMPSE INTO YOUR DAY...

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: • Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves • Review experience reporting for accuracy • Collaborate with consultants and account teams to prepare and deliver client financial presentations • Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions • Manage and oversight of underwriting support team • Renew and market carriers for assigned book of business • Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial...

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBLITIES: Project client claim data to develop budgets, calculate client rates, benefit costs, and IBNR reserves Review experience reporting for accuracy Collaborate with consultants and account teams to prepare and deliver client financial presentations Assess complex client risk, understanding the strategic implications of the competitive carrier/product marketplace, and make sound underwriting-based assumptions Manage and oversight of underwriting support team Renew and market carriers for assigned book of business Analyze / negotiate annual renewals and proposals from carriers for accuracy and financial reasonableness Analyze...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim, Legal Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program,...

Come join our team! There are many reasons why EPIC Insurance Brokers & Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and “bring it” every day, EPIC is always looking for people who have “the right stuff” – people who know what they want and aren’t afraid to make it happen. Headquartered in San Francisco and founded in 2007, our company has over 3,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees. Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your next career? Then consider joining our...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim, Legal Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program,...