Claims Consultant, Life Sciences

CNA Insurance; Brea (CA); On-site; USD 72,000 - 141,000; Full time

Job summary

CNA Insurance in California is seeking a experienced claims professional to manage a portfolio of highly complex commercial claims with large exposures, applying established protocols to verify coverage, investigations, and disbursements within authority.

You will collaborate with insureds, claimants, and partners to deliver timely updates, develop resolution strategies, and ensure compliant reserves and settlements while mentoring less experienced colleagues.

Qualifications

• Bachelor's degree or equivalent experience required.
• Typically six years of relevant experience, preferably in claim handling.
• Must have or obtain an Insurance Adjuster License within 90 days of hire where applicable.
• Prior negotiation experience preferred.
• Professional designations such as CPCU preferred.

Responsibilities

• Manages an inventory of highly complex commercial claims with large exposures.
• Extends exceptional service by updating insureds and partners promptly.
• Verifies coverage and reserves; works with counsel on complex matters.
• Gathers information and conducts focused investigations to determine liability.
• Develops and executes claim resolution strategies and negotiates settlements.
• Manages budgets, resources, and timely payments within authority.
• Identifies subrogation and fraud opportunities for further action.
• Maintains compliance with state/local regulatory requirements and company guidelines.

Skills

Insurance knowledge

Communication

Analytical thinking

Negotiation

Problem solving

Education

Bachelor's Degree

Insurance Adjuster License

CPCU (preferred)

Tools

Microsoft Office

Job description

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

Essential Duties & Responsibilities

• Manages an inventory of highly complex commercial claims with large exposures that require a high degree of technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.
• Ensures exceptional customer service by managing all aspects of the claim, interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing timely updates and responding promptly to inquiries and requests for information.
• Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols.
• Leads focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.
• Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to complex manage litigation and authorizing payments within scope of authority.
• Establishes and manages claim budgets by achieving timely claim resolution, selecting and actively overseeing appropriate resources, authorizing expense payments and delivering high quality service in an efficient manner.
• Realizes and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Claim, Recovery or SIU resources for further investigation.
• Achieves quality standards by appropriately managing each claim to ensure that all company protocols are followed, work is accurate and timely, all files are properly documented and claims are resolved and paid timely.
• Keeps leadership informed of significant risks and losses by completing loss summaries, identifying claims to include on oversight/watch lists, and preparing and presenting succinct case summaries to senior management.
• Maintains subject matter expertise and ensures compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.
• Mentors, guides, develops and delivers training to less experienced Claim Professionals.

May perform additional duties as assigned.

Reporting Relationship

Typically Director or above

Skills, Knowledge & Abilities

• Thorough knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
• Strong communication and presentation skills both verbal and written, including the ability to communicate business and technical information clearly.
• Demonstrated analytical and investigative mindset with critical thinking skills and ability to make sound business decisions, and to effectively evaluate and resolve ambiguous, complex and challenging business problems.
• Strong work ethic, with demonstrated time management and organizational skills.
• Ability to work in a fast-paced environment at high levels of productivity on complex matters.
• Demonstrated ability to negotiate complex settlements.
• Experience interpreting complex commercial insurance policies and coverage.
• Ability to manage multiple and shifting priorities in a fast-paced and challenging environment.
• Knowledge of Microsoft Office Suite and ability to learn business-related software.
• Demonstrated ability to value diverse opinions and ideas.

Education & Experience

• Bachelor's Degree or equivalent experience
• Typically a minimum six years of relevant experience, preferably in claim handling
• Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire where applicable
• Prior negotiation experience
• Professional designations preferred (e.g. CPCU)

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $72,000 to $141,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA’s benefits, please visit cnabenefits.com.

CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [e-mail].