Sr. Claims Consultant - IAS

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

Job summary

The Baldwin Group in California seeks a Senior Workers' Compensation Claims Consultant to provide strategic claims consulting, advocacy, and program management for a designated book of business.

You will advocate with carriers and TPAs, analyze loss trends, and guide return-to-work and cost-control strategies while delivering executive-level reporting and exceptional client service.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 7+ years of California workers' compensation claims handling and related work.
• Expertise in California workers' compensation; multi-state knowledge.
• Strong presentation, negotiation, and communication skills.
• Proficiency with claims analytics and reporting tools.

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.
• 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.

Skills

Presentation

Negotiation

Communication

AI knowledge

Education

Bachelor's degree or equivalent

Professional designations: WCCA, WCCP, ARM, AIC, CPCU

Job description

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.

Click here for some insight into our culture!

The Baldwin Group is a cohesive group of experts in business insurance, employee benefits, retirement planning, and all areas of private and personal insurance. Since 2011, we’ve evolved from a local business into a national firm with a vast network of specializations serving two million clients across the country. At The Baldwin Group, we provide solutions so our clients can pursue what’s possible for themselves, their families, and their businesses. Whether renting a first apartment, opening a small business or taking a company public, we offer solutions to support clients at every step of their journey giving them peace of mind to pursue their purpose, passion, and dreams. We Protect the Possible. The Baldwin Group is an equal employment opportunity firm and strives to comply with all laws prohibiting discrimination based on race, color, religion, age, sex (including sexual orientation and gender identity), national origin or ancestry, disability, military status, marital status, and any other category protected by federal, state, or local laws. All such discrimination is unlawful, and all persons involved in the operations of the firm are prohibited from engaging in this conduct.