Corporate Claims Consultant

Old Republic Commercial Risk; Glen Allen (VA); On-site; USD 130,000 - 190,000; Full time

Job summary

Old Republic Commercial Risk is seeking a senior claims leader to provide technical direction and ensure optimal outcomes for complex claims. The role drives QA programs, policy compliance, and process improvements across the claims staff.

The position requires strong leadership, deep insurance knowledge, and the ability to collaborate with TPAs and internal teams to uphold high standards and ethical practices.

Qualifications

• Bachelor's degree or 5+ years in insurance required.
• Extensive knowledge of insurance contracts and adjusting techniques.
• Familiarity with medical terminology.
• Demonstrated leadership, coaching, and teamwork skills.
• Excellent verbal and written communication skills.
• Proficiency in MS Office (Word, Excel, PowerPoint).
• Supervisory experience; CPCU and AIC or similar designation preferred.

Responsibilities

• Provide technical oversight for unbundled claims with reserve and settlement authority beyond TPA discretionary limits.
• Provide overflow support to bundled claims handled by PMAIC field claims with authority.
• Directly handle an assigned pending of corporately established liability files.
• Support compliance activities related to TPAs.
• Support QA processes to assess work quality and drive improvements.
• Develop and communicate corporate policies; lead project teams resolving claims issues.
• Assess staff training needs and conduct performance improvement sessions.
• Uphold the Company’s Code of Business Conduct and Ethics and apply compliance policies.

Skills

Leadership

Coaching

Teamwork

Communication

Analytical thinking

Negotiation

Decision making

Customer service

Education

Bachelor's degree

CPCU designation

AIC designation

Tools

MS Office

Job description

Provides the highest level of technical direction to the claims staff to ensure appropriate outcomes for claims of the most complex nature. Executes quality assurance programs to evaluate staff adherence to the claim handling standards. Develops and ensures compliance with corporate policies and procedures.

Responsibilities

• Provide technical oversight for unbundled claims assigned to TPA partners inclusive of reserve and settlement authority in excess of TPA discretionary authority limits.
• Provide overflow support to bundled claims handled by PMAIC field claims inclusive of reserve and settlement authority in excess of field authority
• Direct handle an assigned pending of corporately established liability files
• Provide support to various compliance related activities relative to TPA's
• Support Quality Assurance processes to assess quality of work product, identify improvement opportunities and foster discussions that are focused on solutions to enhance results.
• Develops, communicates and ensures compliance with corporate policies and procedures. Leads project teams focused on resolving corporate claims issues.
• Assesses staff training needs and conducts training focused on improving performance.
• Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Requirements

Qualifications

• Bachelor's' degree or 5 or more years of equivalent work experience in an insurance related industry required.
• Extensive knowledge of insurance contracts and adjusting techniques. Familiarity with medical terminology.
• Demonstrated leadership, coaching, and teamwork skills.
• Advanced skills in applying sound judgment/analysis, decision making/problem solving, planning and organization and negotiation.
• Demonstrated customer service and collaboration skills.
• Excellent verbal and written communication skills.
• Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
• Previous supervisory experience, Chartered Property Casualty Insurance (CPCU) and Associate in Claims (AIC), or similar professional designation, desired.