Corporate Claims Consultant

Old Republic Commercial Risk; Mount Laurel Township (NJ); On-site; USD 120,000 - 170,000; Full time

Job summary

Old Republic Commercial Risk provides the highest level of technical direction to the claims staff to secure outcomes for the most complex cases. This role oversees quality assurance programs and ensures adherence to corporate standards and procedures.

The position leads claim handling, supports compliance activities with TPAs, and drives staff development through training. Strong leadership, judgment and communication are essential to succeed in this high-responsibility environment.

Qualifications

• Bachelor's degree or 5+ years of equivalent work experience in insurance.
• Extensive knowledge of insurance contracts and adjusting techniques.
• Strong leadership, coaching and teamwork skills.
• Advanced judgment, analysis, and negotiation abilities.
• Excellent verbal and written communication and collaboration.
• Proficiency with MS Office (Word, Excel, PowerPoint).

Responsibilities

• Provide technical oversight for high-risk claims and reserve/settlement decisions.
• Lead quality assurance and compliance initiatives across policies and procedures.
• Coordinate training to improve performance and discuss findings with teams.
• Support TPA and external partners with complex coverage and liability files.

Skills

Leadership

Coaching

Teamwork

Decision making

Problem solving

Negotiation

Communication

Customer service

Collaboration

MS Office

Education

Bachelor's degree or 5+ years experience in insurance

CPCU / AIC or similar designation desired

Tools

MS Office Suite

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.