Senior Claim Consultant

**SUMMARY:** The Senior Claims Consultant will provide claim advocacy and oversight services for Tier 1, 2 & 3 clients for property and casualty and worker's compensation losses. Services include but are not limited to, assuring complete and sound claim settlements, legal reviews and investigation, providing clients and/or carrier adjusters with leadership, direction, and problem resolution, as well as reviewing and monitoring files to ensure adjusters are achieving desired quality and service levels and functions. **ESSENTIAL FUNCTIONS:** - Work directly with the Claims Manager to develop performance and service standards; assist in the preparation, implementation and monitoring of the Risk Management Services department’s claims management plans and client service responsibilities - Provide management reports as required by senior management to monitor performance - Trains and mentors junior claim colleagues as needed - Will undergo training and mentorship from the Director of Risk Management Services as needed - Evaluate claim documentation to ensure coverage accuracy - Update EPIC with new & ongoing claims information, as needed - Respond to phone calls to handle difficult customers or claims situations with adjusters where needed - Answer inquiries and questions from insureds, 3^rd^ Party claimants, and colleagues. - Prepare Quarterly, Semi-annual or Annual Loss Summaries - Assist Claims Manager in creating Special Claims Service Plans for VIP customers - Review all loss details for clarification of expenses versus indemnity on loss runs or closing notices; analyze claims for financial impact to client and company - Follow-up for subrogation, depending on the type of claim - Review of time lapsed from date of loss to date reported and indicate lapse times to producer and customer - Rectify with carriers the status of all open claims - Review client lawsuits, larger losses (large reserves), and more complex claims and coverage scenarios - Compare prior year loss runs to current year loss runs (reserve analysis for Work Comp loss runs) to determine if reserves are higher/lower, and refer to the type of injury - Review and prepare an analysis of new Work Comp laws applicable to Texas and/or Oklahoma - Engages in field inspections for claim resolutions as needed - Periodic meetings with producers and carrier claims representatives to solve issues or potential concerns regarding current customers, acting as liaisons between client and carrier (including client claim reviews) , and establishing Special Handling Instructions - Accompany Team members on prospect calls when necessary - Seeks assistance from Loss Control & Risk Management Services to solve high-level claims issues. Involve Loss Control whenever hazards are found during the course of a claim in an effort to reduce future claim occurrences - Assist Producers with those Tier level customers enrolled in the INSURICA Work Comp Experience, including, but not limited to, reviewing NCCI Worksheets and Mod-Master reports - Advise producers/account managers of large claims settlements/reserves per established guidelines. Inform producers of the status of large or complex claims - Maintain and distribute Agency Claims Log, Large Loss Reports, and Litigated Claims Reports - Maintain working knowledge of all company change procedures - Conduct claims training seminars for clients and colleagues - Stays current on developing legislative & regulatory changes that will impact INSURICA claims advocacy efforts and educate clients & colleagues of these changes - Review all activities relating to the public, customers, and companies to avoid issues involving potential errors and omissions - Participate in seminars and other training to maintain required licenses and pursue/maintain relevant designations/certifications, as well as for knowledge and skill development *ADDITIONAL RESPONSIBILITIES:* This job description is intended to describe the level of work required of the person per…