Associate Claims Consultant

Job Summary:

• Monitors claims activities, facilitates resolutions, and reviews claim status and reserves using advanced problem-solving skills.
• Acts as liaison between Clients and insurance carriers, advocating for optimal outcomes while respecting carrier processes.
• Ensures accuracy of claim forms, analyzes data, and generates reports to inform business strategies.
• Develops and manages Claims Management Programs, coordinating client meetings and reviews.
• Performs cost containment surveys, negotiates reserve adjustments, and provides loss analysis and recommendations.
• Builds strong relationships with stakeholders, researches industry trends, and ensures compliance with regulations.
• Other duties include leading audits, developing service plans, and attending training sessions.

Requirements:

• Bachelor's degree or equivalent experience in insurance claim management.
• Knowledge of Third Party Administrators, claims reserving, and insurance coverage.
• Proficiency in Microsoft Office, strong communication skills, and ability to work independently and travel as needed.
• Ability to work outside normal hours, organize work efficiently, and maintain confidentiality.
• Legally authorized to work in the U.S.