Technical Consultant Casualty Claims

Hanover Insurance Group, Inc.; Michigan; Hybride; USD 110 000 - 140 000; Plein temps

Résumé du poste

Hanover Insurance Group, Inc. in Michigan seeks a Technical Consultant, Casualty Claims to manage high-complexity no-fault claims with a focus on coverage analysis, medical bill review, and coordinated settlements, working in a hybrid office-based role.

You will collaborate with legal counsel, SIU, and medical experts, mentor junior staff, and ensure compliance with no-fault statutes while maintaining high professional standards.

Qualifications

• Bachelor’s degree preferred or equivalent experience; typically 5+ years in the claims field.
• Recognized authority in negotiating highly complex claims.
• Strong analytical, negotiation, and decision-making skills.
• Excellent written and verbal communication; handles sensitive issues professionally.
• Maintains organized claim records and prepares detailed reports.
• Deep insurance knowledge and regulatory understanding.
• Independent decision-making and risk analysis.
• Mentors others and contributes to policy development.

Responsabilités

• Investigate moderate to complex and sensitive claims with thorough analysis.
• Collaborate with internal and external experts to evaluate claims.
• Identify subrogation opportunities and manage disputes through negotiation.
• Set reserves and authorize payments within authority limits; manage litigation budgets.
• Lead cross-functional meetings and communicate complex information clearly.

Connaissances

Analytical Reasoning

Customer Centricity

Digital Fluency

Persuasion and Influence

Professional Insurance Acumen

Planning and Execution

Formation

Bachelor’s degree preferred or equivalent experience

Description du poste

Our Claims team is currently seeking a Technical Consultant Casualty Claims.

This is a full-time, exempt role with a hybrid work schedule (two days in the office) in one of our Hanover offices:

• Howell, MI / Farmington Hills, MI
• Southfield, MI

POSITION OVERVIEW:

The Technical Consultant, Casualty Claims, manages high-complexity no-fault claims involving moderate to high injury and disability severity. Duties include thorough coverage analysis, evaluating medical bills and other no-fault benefits for payment consideration, coordination and contact with claimants, third-parties and medical providers, skillfully negotiating settlements, and/or oversight of litigation strategy. Technical Consultants will collaborate with legal counsel, SIU teams, and medical experts to resolve claims efficiently while ensuring compliance with no-fault statutes and contributing to mentoring early in career staff.

This role requires advanced investigative and negotiation skills to resolve disputes and handle escalated situations, while collaborating with legal teams and subject matter experts as needed. The consultant analyzes complex data, provides expert opinions to support claim resolution, and may represent the company in litigation forums. Operating with a high degree of autonomy and professionalism, the position demands strategic thinking, deep technical expertise, and strict adherence to regulatory and company standards in navigating sensitive, high-impact claim scenarios.

IN THIS ROLE, YOU WILL:

• Independently investigate moderate to complex and sensitive claims, ensuring thorough analysis and resolution.
• Collaborate with internal and external experts to evaluate claims and determine validity and value.
• Identify opportunities to transfer risk and pursue subrogation. Proactively resolve disputes, deescalate sensitive situations, and ensure optimal claim outcomes through strategic negotiation and litigation management.
• Assess and transfer risk where appropriate; manage suspicious claims and refer to SIU as needed.
• Serve as a subject matter expert and contribute to departmental projects and initiatives.
• Draft coverage letters, including complex forms and endorsements; interpret commercial coverages and legal principles.
• Set reserves and authorize payments within high authority limits; manage litigation budgets and counsel.
• Lead quality and efficiency initiatives for complex claims workflows.
• Use technology and data tools to identify trends, correct inconsistencies, and optimize outcomes.
• Negotiate high-value and contested claims using advanced strategies.
• Ensure compliance with jurisdictional requirements; mentor others on regulatory standards.
• Maintain accurate records and prepare detailed reports; protect PII and educate peers on best practices.
• Lead cross-functional meetings and drive consensus on claim resolutions.
• Communicate complex information clearly to diverse stakeholders; manage sensitive customer interactions.
• Provide technical guidance and mentorship to less experienced adjusters.
• Represent the company in litigation forums including trials, mediations, and arbitrations.
• Support training development and evaluate program effectiveness.
• Influence product development by identifying coverage gaps and recommending updates.
• Attend industry events and continuing education seminars to stay current with best practices, legal developments, and emerging trends.
• Must possess or obtain and maintain appropriate state adjuster licenses and continuing education credits.

WHAT YOU NEED TO APPLY:

• Bachelor’s degree preferred or equivalent experience; typically 5+ years of industry experience; industry designation relevant to the role preferred.
• Recognized authority in negotiating highly complex claims; shapes and implements best practices.
• Skilled in negotiating complex claims and developing strategies to influence outcomes. Demonstrates sound judgment and decision-making on high-exposure cases, including litigation and compliance matters.
• Communicates clearly and effectively in verbal and written formats; handles sensitive and complex issues with professionalism. Selects appropriate communication channels and consistently demonstrates empathy.
• Maintains comprehensive and organized claim records and prepares detailed reports summarizing findings and recommendations.
• Highly organized with the ability to manage complex workflows and participate in project work. Demonstrates strong time management and desk management skills, and mentors others in these areas.
• Expert-level insurance knowledge; deep understanding of legal and regulatory frameworks.
• Makes informed decisions independently; analyzes risks and understands financial impacts.
• Exercises sound judgment and strategic insight in evaluating results and shaping policy.
• Develops investigative techniques and protocols; expert in coverage analysis and liability assessment.
• Designs empathetic customer service strategies; recognized for exceptional service.

Core Capabilities:

• Analytical Reasoning: The ability to identify problems, understand your impact, gather input and data, and develop an effective solution.
• Customer Centricity: Makes customers/clients and their needs a primary focus of one’s actions; shows interest in and understanding of the needs and expectations of internal and external customers; gains customer trust and respect; meets or exceeds customer expectations.
• Digital Fluency: Effectively uses digital tools and technology appropriately to find, evaluate, create, and communicate information understands how to navigate digital platforms, use software applications, and leverage technology for productivity and communication purposes.
• Persuasion and Influence: Uses appropriate interpersonal skills and techniques to gain acceptance for ideas or solutions; uses influencing strategies to gain genuine agreements; seeks to persuade rather than force solutions or impose decisions or regulations.
• Professional Insurance Acumen: Demonstrates a deepening understanding of the insurance industry and the ability to apply specialized technical skills to address complex challenges, adapt to industry trends, and drive value for the organization.
• Planning and Execution: Plans, prioritizes and manages resources and time effectively to achieve specific goals or deadlines.

This job posting provides cursory examples of some of the job duties associated with this position. The examples provided are not complete, and the position may entail other essential and job-related functions and responsibilities that employees will be required to perform.