Sr. Claims Consultant - IAS

The Baldwin Group; Tustin (CA); On-site; USD 99,000 - 121,000; Full time

Job summary

The Baldwin Group is seeking an experienced Senior Workers' Compensation Claims Consultant to join our Risk Mitigation Service team. You will be the primary claims consultant for a designated book of business, advocating for clients with carriers, TPAs, and defense counsel to achieve favorable outcomes.

Ideal candidates possess California workers' compensation expertise, strong analytics, and outstanding client service, with a track record of influencing claim strategy and cost reduction.

Qualifications

• 7+ years of workers' compensation claims handling or related experience.
• Expertise in California workers' compensation with multi-state knowledge.
• Strong presentation, negotiation, and communication skills.

Responsibilities

• Serve as the primary workers' compensation claims consultant for a designated book of business.
• Advocate on behalf of clients with carriers, TPAs, defense counsel, and medical management vendors to drive favorable claim outcomes.
• Conduct claim file reviews and identify opportunities to reduce claim duration, improve reserve accuracy, and control total cost of risk.
• Monitor large-loss, catastrophic, and complex workers' compensation claims.
• Participate in claim strategy meetings and provide recommendations regarding return-to-work initiatives, litigation management, settlement opportunities, and claim resolution.

Education

Bachelor's degree or equivalent

WCCA

WCCP

ARM

AIC

CPCU

Job description

• Professional designations desired such as WCCA, WCCP, ARM, AIC, CPCU

The Baldwin group is an award-winning entrepreneur-led and inspired insurance brokerage firm delivering expertly crafted commercial insurance and risk management, private insurance and risk management, employee benefits and benefit administration, asset and income protection, and risk mitigation strategies to clients wherever their passions and businesses take them throughout the U.S. and abroad. The Baldwin group has award-winning industry expertise, colleagues, competencies, insurers, and most importantly, a highly differentiated culture that our clients consider an invaluable expansion of their business. The Baldwin group takes a holistic and tailored approach to insurance and risk management.

We are seeking an experienced and client-focused Senior Workers' Compensation Claims Consultant to join our Risk Mitigation Service team. This role serves as a trusted consultant to our clients, insurance carriers, third-party administrators (TPAs), and internal account teams by providing strategic workers' compensation claims consulting, advocacy, and program management services.

The ideal candidate will possess extensive workers' compensation claims expertise, strong analytical and communication skills, and a proven ability to influence positive claim outcomes while delivering exceptional client service.

Primary Responsibilities

Claims Consulting & Advocacy

• Serve as the primary workers' compensation claims consultant for a designated book of business.
• Advocate on behalf of clients with carriers, TPAs, defense counsel, and medical management vendors to drive favorable claim outcomes.
• Conduct claim file reviews and identify opportunities to reduce claim duration, improve reserve accuracy, and control total cost of risk.
• Monitor large-loss, catastrophic, and complex workers' compensation claims.
• Participate in claim strategy meetings and provide recommendations regarding return-to-work initiatives, litigation management, settlement opportunities, and claim resolution.

Client Service & Relationship Management

• Develop strong relationships with clients and become a trusted advisor on workers' compensation claim trends and best practices.
• Lead client claim review meetings and stewardship presentations.
• Interpret claims data and prepare executive-level reports and recommendations.
• Support client retention and growth initiatives through exceptional service and thought leadership.
• Collaborate with producers, account executives, and service teams to support new business and existing client opportunities.

Program Analytics & Reporting

• Analyze loss trends, reserve practices, and claim outcomes.
• Identify emerging claim trends and risk exposures impacting client programs.
• Partner with loss control and identify claim management strategies designed to reduce costs and improve program performance.

Technical Expertise

• Maintain a current understanding of workers' compensation laws, regulations, and industry trends.
• Provide technical guidance and mentoring to junior claims consultants and service team members.
• Stay informed regarding carrier claim practices, medical cost containment initiatives, and claim management best practices.

Preferred Education

• Experience working for an insurance brokerage, insurance carrier, self-insured employer, or third-party administrator.
• Professional designations desired such as WCCA, WCCP, ARM, AIC, CPCU.
• Experience preparing and delivering executive-level stewardship presentations.
• AI knowledge and experience.

Education & Experience

• Bachelor's degree or equivalent combination of education and experience.
• 7+ years of workers' compensation claims handling, claims consulting, brokerage claims advocacy, TPA management, or carrier claims experience.
• Expertise in California workers' compensation claims with strong working knowledge of multi-state workers' compensation programs.
• Advanced knowledge of workers' compensation claims administration and litigation management.
• Experience reviewing reserves, claim strategies, medical management programs, and complex claim exposures.
• Strong presentation, negotiation, and communication skills.
• Proficiency with claims analytics and reporting tools.
• Ability to manage multiple priorities while maintaining exceptional client service.

Other

Fast paced, multi-tasking environment.

Travel may be required.

Important Notice

This position description is intended to describe the level of work required of the person performing in the role and is not a contract. The essential responsibilities are outlined; other duties may be assigned as needs arise or as required to support the organization. All requirements may be subject to reasonable accommodation to applicants and colleagues who need them for medical or religious reasons.

The starting pay is $110,000 salary. Salary is negotiable upon time of offer.

The Baldwin Group will not accept unsolicited resumes from any source other than directly from a candidate who applies on our career site. Any unsolicited resumes sent to The Baldwin Group, including unsolicited resumes sent via any source from an Agency, will not be considered and are not subject to any fees for any placement resulting from the receipt of an unsolicited resume.