Claim Consultant

Overview

The Claim Consultant provides complete claim loss services for policyholders, investigating, evaluating, and disposing of MPL and General Liability claims of varying complexity and severity. The role works independently to manage claims and coordinate with teams to achieve optimal outcomes.

• Interview insureds, claimants, witnesses, and other appropriate parties to assess liability exposure.
• Document investigation and negotiation findings and prepare reports for established diary dates and other required reports.
• Secure records for investigation and evaluation of cases.
• Determine and implement negotiation strategy; negotiate settlements within authority level.
• Adjust reserves as authorized and recommend reserves above authority level to Manager/Director.
• Advise the Claim Director or S.V.P. of Claims on claim status and attend Reserve & Settlement Committee meetings as needed.
• Ensure timely reporting to the Reserve & Settlement Committee.
• Coordinate with other departments to facilitate and support insureds and clients.
• Evaluate cases for disposition, seek settlement authority from Manager/Director when needed.
• Direct and monitor defense counsel activities per Case Management Guidelines.
• Monitor trials and attend pre‑trial proceedings, mediations, and arbitrations as required.
• Identify significant insured Risk Management or Underwriting issues and direct relevant information to appropriate department.
• Communicate with insureds, claimants, and witnesses; consult medical and other records; employ investigation methods based on claim type.
• Analyze and verify insurance coverage for claims against policyholders.
• Maintain working knowledge of policy forms and confirm policy in effect for loss date.

• Bachelor’s degree from a four‑year college or university.
• R.N. or J.D. preferred, with 3‑5 years of clinical nursing experience or 3‑5 years of claims experience dealing with serious bodily injury.
• Knowledge of medical, legal and insurance terminology required.
• Current driver’s license.
• Strong written and oral communication skills.
• Training in contract and policy review and application.
• Comfortable making oral presentations to staff and insureds.
• Ability to synthesize complex information; collect, research and analyze data; design workflows and procedures.
• Creative problem‑solving and solution design skills.
• Insurance adjuster’s license may be required for specific states.
• Ability to travel 25‑30% of time.

Salary range: $87,500 – $118,500, based on location, skill set, experience, qualifications and education.

Benefits package is available Day1 of employment.

Coverys is an equal‑opportunity employer. Coverys’ job openings are open to all without regard to race, color, national origin, gender, gender identity, religion, age, height, weight, disability, political beliefs, sexual orientation, marital status, family status, or veteran status.