Job Summary: We are seeking an experienced Claim Consultant to join our team and support Client's Claim Closure Services (ACCS) Practice. In this role, you will provide high-quality consulting services to our clients, focusing on the strategic management of Workers’ Compensation claims. You’ll work both independently and collaboratively to handle various phases of claim management, ensuring optimal outcomes for our clients. Key Responsibilities: Claim Review & Strategy Development: Review claim activity to ensure compliance with industry best practices. Assess the handling of Workers’ Compensation (WC) claims and recommend strategies for improvement. Develop aggressive and effective strategies for legacy claims (older than 12 months) to either achieve resolution or minimize costs. Claims Management & Monitoring: Monitor adjuster activity to ensure the execution of established strategies. Evaluate claim reserves and settlement exposures to manage financial risks effectively. Review and assess the appropriateness of legal strategies in the claims process. Consultative Support: Provide expert guidance on high-dollar settlement negotiations, litigation strategies, and Medicare Set-Aside (MSA) considerations. Support the broader ACCS team in delivering exceptional client service and strategic consulting. Required Qualifications: Minimum of three years of experience adjusting Workers’ Compensation lost-time and litigated claims. Strong expertise in managing lost-time claims, including: High-dollar settlement negotiations Litigation strategy development Medicare Set-Aside (MSA) management Proven ability to work both independently and within a team-oriented environment. Strong analytical, problem-solving, and decision-making skills. Excellent communication and interpersonal abilities to engage with clients, adjusters, and legal teams. Preferred Qualifications: Experience with claims management software and tools. Knowledge of current WC laws, regulations, and industry trends. Ability to mentor or guide junior staff on claims handling best practices. Certifications: None required, though relevant certifications in insurance claims or risk management are a plus. Compunnel
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