Workers Compensation TPA Oversight Claims Consultant

01460 Continental Casualty Company; Downers Grove (IL); On-site; USD 72,000 - 141,000; Full time

Job summary

CNA is seeking an experienced individual contributor to provide technical oversight of highly complex commercial Workers’ Compensation claims managed by TPAs. You will guide strategies, reserves, and resolution plans to align with company protocols and regulatory requirements.

The role emphasizes leading through influence by partnering with TPAs, clients, and internal stakeholders to achieve optimal claim outcomes and customer service standards within CNA.

Qualifications

• Bachelor's degree or equivalent experience required.
• Professional designation preferred.
• Typically a minimum eight years claims experience.

Responsibilities

• Manage highly complex investigations of claims, including coverage, liability, and damages.
• Determine if a major claim should be settled or litigated and implement an appropriate resolution strategy.
• Effectively manage loss costs and claim expenses.
• Coordinate discovery and litigation strategy with staff counsel or panel attorneys.
• Provides guidance to less experienced claims staff and other functional areas.

Skills

Advanced claims expertise

Communication skills

Negotiation skills

Analytical skills

Microsoft Office

Education

Bachelor's degree or equivalent

Professional designation

Tools

Microsoft Office Suite

Job description

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

This individual contributor position works under general direction, and within broad authority limits, to provide technical oversight of complex, high-exposure commercial Workers’ Compensation claims handled by Third-Party Administrators (TPAs). While not responsible for people management, the role functions as a subject matter leader, influencing claim outcomes through expertise, collaboration, and oversight. The position is responsible for reviewing and guiding claim strategies, reserves, and resolution plans to ensure alignment with company protocols, regulatory requirements, and best practices. Success in this role requires the ability to lead through influence by setting expectations, partnering effectively with TPAs, clients, and internal stakeholders, and driving accountability for quality, compliance, and performance through consultative engagement and clear communication. The role may support designated accounts and requires regular interaction with internal and external partners to achieve optimal claim outcomes and customer service standards.

Essential Duties & Responsibilities

• Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages.
• Determines if a major claim should be settled or litigated and implements an appropriate resolution strategy accordingly.
• Effectively manages loss costs and claim expenses.
• Manages all types of investigative activity or litigation on major claims, including the posting of appropriate reserves in a timely manner.
• Coordinates discovery and litigation strategy with staff counsel or panel attorneys.
• Negotiates highly complex settlement packages, and authorizes payment within scope of authority, settling claims in most cost effective manner and ensuring timely issuance of disbursements.
• Coordinates third party recovery with subrogation/salvage unit.
• Makes recommendations on claims processes and resolution strategies to management.
• Analyzes claims activities; prepares and presents reports to management and other internal business partners and clients.
• Works with attorneys, account representatives, agents, doctors and insureds regarding the handling and/or disposition of highly complex claims.
• Keeps current on state/territory regulations and issues, industry activity and trends.
• May participate in industry trade groups.
• Provides guidance and assistance to less experienced claims staff and other functional areas.
• Responsible for input of data that accurately reflects claim circumstances and other information important to our business outcomes.
• Reporting Relationship Manager or above.

Skills, Knowledge and Abilities

• Advanced technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.
• Strong communication, negotiation and presentation skills.
• Ability to effectively interact with all levels of CNA's internal and external business partners.
• Advanced analytical and problem solving skills, with the ability to manage and prioritize multiple projects.
• Ability to deal with ambiguous situations and issues.
• Creativity in resolving unique and challenging business problems.
• Knowledge of Microsoft Office Suite and other business-related software.
• Ability to adapt to change and value diverse opinions and ideas.
• Ability to manage and prioritize multiple projects.
• Ability to evaluate claims based on a cost benefit analysis.
• Ability to fully comprehend complex claim facts and issues; and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
• Ability to implement strategies with a proactive long-term view of business goals and objectives.

Education and Experience

• Bachelor's degree or equivalent experience.
• Professional designation preferred.
• Typically a minimum eight years claims experience.

Compensation

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $72,000 to $141,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location.

Benefits

CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA’s benefits, please visit cnabenefits.com. CNA utilizes AI-enabled technology during the recruiting process. For more information, please visit our careers page. CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [e-mail]

Company Culture

At CNA, we are focused on success, individually and collectively. We pride ourselves on promoting a culture that challenges and engages people. We strive to connect people, departments and business areas, to function as a team, and to serve our customers and communities with professionalism and respect. Our dedication to employee engagement, continuous learning and the open exchange of ideas is the cornerstone of our business.

These ideals, combined with our focus on the customer, enable us to explore new market opportunities and build on our success. Our values, culture and financial strength are what differentiates us from other employers and make CNA the place you want to work.

At CNA, we are committed to advancing a culture of inclusion – one that attracts talent from all walks of life, foster respect and collaboration, and enables all of our colleagues to do their best work. At CNA, we have a long standing commitment to the diverse communities in which we live and work. We actively make a difference for the greater good through partnerships, sustainability, initiatives, and working together for a better tomorrow. Corporate Social Responsibility is not one person, or one department, it's the entire enterprise coming together to make the world a better place.