12 complex claims consultant jobs found

Job Description: We are looking to add a Sr. Workers’ Compensation Claims Specialist, Supervisor to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in multiple states . This team member will provide high quality claims handling oversight and expertise for all CRS customers on litigated and complex claim situations. This includes assisting staff supervised with investigating, communicating, evaluating, and resolving claims utilizing the CRS Best Practice of Claim Handling. Assisting claim staff with goals, career pathing, and ensuring engagement. Essential Responsibilities: Claims Management: Adjudicate claims during staffing shortages, investigate, and negotiate settlements per “Best Practices for Claims.” Monitor and document claim files, focusing on Coverage, Investigation, Reserves, Plan of Action, Legal, and Medical Management. Recommend adjustments as needed. Research and respond to questions and complaints...

If you’re passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. This role will handle commercial underwriting for Human Services & Non-Profit. Qualified candidates must have commercial underwriting experience, with authority. The most ideal candidates will also possess underwriting experience in the Social Services, Human Services, Religious Org and/or Non-Profit lines of business. This role does not qualify for employer-sponsored work authorization.  Nationwide does not participate in the Stem OPT Extension program. #LI-MS1 #LI-REMOTE Job Description Summary Success on our...

If you’re passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Work Environment: The location of this position is flexible and open to virtual and/or remote based applicants. What to expect: This individual will manage a varying degree of workers compensation claim complexity for all Nationwide channels; inclusive but not limited to: Agribusiness, Standard Commercial, and E&S. Members are unique in that they could be commercial business owners, farms, small businesses, or amusement parks. The ideal candidate will have: Strong workers compensation, or loss time claims...

Company: Marsh Description: We are seeking a talented individual to join our Insurance Sales Consultant team at Marsh . This role will be based in Urbandale . This is a hybrid role that has a requirement of working at least three days a week in the office. As an Insurance Sales Consultant, you will play a key role in building strong customer relationships, consulting on products, and driving sales growth while ensuring customer satisfaction. We will count on you to: Perform critical client functions, including evaluating risks, developing solutions, and making recommendations to clients across the supported product line. Build and maintain relationships with clients to provide best in class service to drive growth and retention. Serve as a client contact for day-to-day needs and answer standard client questions to improve the client experience. Work closely with external and internal business partners to provide customer feedback and partner in creating...

Company: Marsh Description: We are seeking a talented individual to join our team at Marsh . This role will be based in Urbandale, Iowa . This is a hybrid role that has a requirement of working at least three days a week in the office. As a key contributor, you will focus on building strong customer relationships and maintaining retention by consulting with customers on products and services. Collaborate with both internal and external business contacts to resolve customer issues and enhance the overall customer experience and coverage offerings. We will count on you to: Perform critical client functions, including evaluating risks; developing solutions; articulating impact of options; leveraging prepared analytics and making recommendations to client across supported product line. Build and maintain relationships with clients to provide best in class service to drive growth and retention. Serve as a client contact for day-to-day needs and answers standard...

Company Details   Company URL: https://www.berkleytechnologyservices.com/                                           Berkley Technology Services (BTS) is the dynamic technology solution for W. R. Berkley Corporation, a Fortune 500 Commercial Lines Insurance Company. With key locations in Urbandale, IA and Wilmington, DE, BTS provides innovative and customer-focused IT solutions to the majority of WRBC’s 60+ operating units across the globe. BTS’s wide reach ensures that ideas and opinions are considered at every level of the organization to guarantee we find the best solutions possible.     Driven by a commitment to collaboration, BTS acts as consultants to our customers and Operating Units by providing comprehensive solutions that not only address the challenge at hand, but proactively plan for the “ What’s Next ” in our industry and beyond.     With a culture centered on innovation and entrepreneurial spirit, BTS stands as a community of...

Job Description: We are looking to add a Client Service Consultant to join our Property Casualty team in Cedar Rapids, IA . Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes!   Essential Responsibilities: Attend insurance carrier meetings and ability to independently lead client meetings, as required. Working accounts start to finish; may have some Client Service Specialist support and/or supporting Sr. Client Service Consultant, servicing larger, more complex accounts. Consult with the team for pre-renewal meetings on qualifying accounts and development of client opportunities. Market renewal policies and negotiate with insurance company underwriters. Review quotes on accounts for accuracy and prepare proposal documents for client. Be accountable for account and policy accuracy by ensuring that all customer information as...

Job Description: We are looking to add a Liability Claims Specialist to join our Creative Risk Solutions team. This team member will provide high-quality claims handling and expertise for CRS customers, including investigating, evaluating, and resolving auto and general liability claims, potentially involving litigated files. We offer a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Creative Risk Solutions!   Essential Responsibilities: ·   Review coverage for commercial auto and general liability claims. ·   Adjudicate claims, investigate bodily injury/liability claims, and negotiate settlements using "Best Practices for Claims." ·   Maintain accurate loss information and establish/maintain reserves within authority. ·   Research and respond to questions and complaints from insureds, claimants, agency partners, and carriers. ·...

Cottingham & Butler is seeking a Director of Pharmacy Services to lead the continued growth and integration of pharmacy expertise within our Employee Benefits practice. This role represents a strategic investment in expanding our clinical capabilities, advancing our analytical and consulting platforms, and driving innovative strategies that improve affordability, outcomes, and value for our clients. The Director of Pharmacy Services will bring a blend of clinical insight, business acumen, and leadership to evolve how we approach pharmacy management in the employer market. This position will oversee our pharmacy consulting direction across the brokerage while also assisting wholesale channels, working closely with analysts, consultants, and leadership teams to deliver best-in-class pharmacy strategy and results. Key Responsibilities Lead Pharmacy Strategy: Direct the vision, structure, and execution of our pharmacy consulting initiatives, ensuring alignment with...

Cottingham & Butler is seeking a Director of Pharmacy Services to lead the continued growth and integration of pharmacy expertise within our Employee Benefits practice. This role represents a strategic investment in expanding our clinical capabilities, advancing our analytical and consulting platforms, and driving innovative strategies that improve affordability, outcomes, and value for our clients. The Director of Pharmacy Services will bring a blend of clinical insight, business acumen, and leadership to evolve how we approach pharmacy management in the employer market. This position will oversee our pharmacy consulting direction across the brokerage while also assisting wholesale channels, working closely with analysts, consultants, and leadership teams to deliver best-in-class pharmacy strategy and results. Key Responsibilities Lead Pharmacy Strategy: Direct the vision, structure, and execution of our pharmacy consulting initiatives, ensuring alignment with...

The Medical Allocator creates a cost projection of a patient’s medical treatment needs by reviewing medical records and identifying a pattern of care. The medical cost projection, also knowns as a Medicare Set-Aside (MSA) report, is part of a workers’ compensation or liability claim settlement.  The Medical Allocator will rely on their medical knowledge and guidelines provided by the Centers for Medicare and Medicaid Services (CMS) to evaluate the patient’s treatment plan for future medical treatment needs.  Work from home possible.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collaboration with the claim adjuster Review medical records to prepare a Medicare Set-Aside allocation (MSA) report Perform evidenced based medical research Utilize medical knowledge to outline the patient’s medical treatment. Assign pricing to medical treatment allocations Assign pricing to medication allocations Prepare submission of MSA report to CMS for review and approval...

Job Description: Sr. Financial Consultant, EB – Waukee, IA We are looking to add a Sr. Financial Consultant to join our Employee Benefits team in Waukee, IA . Offering a forward-thinking, innovative, and vibrant company culture, along with the opportunity to share your unique potential, there really is no place like Holmes! Essential Responsibilities: To support the financial planning and analysis functions for Holmes Murphy Employee Benefits clients, focusing on data analysis, financial modeling, and regulatory compliance. The individual in this role will work in accordance with the established objectives and procedures of Holmes Murphy & Associates. Essential Responsibilities: Provides Financial consulting and strategic insights to clients with respect to their employee benefit health and welfare plans; runs financial/clinical components of client meetings. Analyzes client monthly financial reporting (MFSR) and presents MFSRs to strategic...