Claims Consultant (Workers' Compensation)

Claims Consultant (Workers' Compensation) Make an Impact Where It Matters Most As a Claims Consultant , you'll play a critical role in helping our agency deliver exceptional claims service while ensuring compliance, consistency, and continuous improvement across our workers' compensation claims operations. As you grow into the role, we expect that this position would expand to multi-line consulting. In this role, you'll serve as a trusted advisor and subject matter expert, partnering with claims professionals, leadership, and cross-functional teams to strengthen claims practices, navigate regulatory requirements, and identify opportunities for innovation. Whether you're auditing claim files, developing claims programs, improving processes, or helping ensure accurate data reporting, your expertise will directly contribute to outstanding client service and operational excellence. If you're passionate about workers' compensation claims, enjoy solving complex problems, and thrive in a collaborative environment where your ideas are valued, we'd love to meet you. What You'll Do Claims Quality & Compliance Conduct regular claims audits to promote consistent claim handling practices and adherence to agency standards, regulatory requirements, and industry best practices. Analyze claim results, identify trends and opportunities for improvement, and communicate actionable recommendations to claims leadership. Interpret workers' compensation laws, regulations, bulletins, and emerging legislative changes, providing practical guidance to claims teams and leadership. Serve as a trusted resource on coverage interpretation, claims investigation best practices, regulatory compliance, and claims philosophy. Training & Development Create and maintain reference guides and educational resources that support ongoing professional development. Partner with agency leadership to identify training opportunities and reinforce best practices through coaching and follow-up. Process Improvement & Collaboration Collaborate with leadership and cross-functional teams to identify opportunities to improve claims processes, workflows, systems, and operational efficiency. Participate in projects involving process improvements, vendor evaluations, and business initiatives. Monitor industry trends and emerging best practices, recommending innovative solutions that strengthen our internal and claims operations. Build strong partnerships across departments to ensure solutions meet business needs and enhance the client experience. Data & Reporting Research, analyze, and resolve Workers' Compensation data errors to ensure accurate and timely state reporting. Reconcile reports and state acknowledgements to maintain data integrity. Partner with claims professionals to ensure required data elements are captured and submitted accurately. General Responsibilities Foster a positive, collaborative, and professional work environment. Maintain confidentiality and exercise sound judgment in all aspects of the role. Travel occasionally for training, professional development, or business meetings as needed. Perform other duties and special projects as assigned. What You Bring Education Bachelor's degree preferred, or an equivalent combination of education and relevant professional experience. Experience Three to five years of experience handling casualty and Workers' Compensation claims. Qualifications Strong knowledge of workers' compensation claims handling, coverage interpretation, and claims best practices. Familiarity with medical cost containment practices, including experience working with ancillary programs such as physical therapy, diagnostics, and pharmacy. Understanding of multi-state workers' compensation regulations and reporting requirements. Excellent analytical, critical thinking, and problem-solving skills. Strong written, verbal, and interpersonal communication skills. Ability to build collaborative relationships across departments and influence positive outcomes. Highly organized with the ability to manage multiple priorities independently. Comfortable adapting to changing priorities while maintaining a high level of quality and accuracy. Preferred Qualifications Familiarity with IAIABC Claims standards and reporting guidelines. Experience working with claims management systems and TPAs. Experience participating in process improvement or operational excellence initiatives. Why You'll Love Working Here We're more than an insurance agency—we're a team that believes great people create great experiences for our clients and each other. We invest in our employees by fostering a collaborative culture where your expertise is valued, your ideas are welcomed, and your professional growth is encouraged. Our work is guided by five core values: Connection – We lead with empathy and build strong relationships. Diligence – We work with focus, determination, and purpose. Innovation – We challenge the status quo and embrace fresh thinking. Integrity – We do what's right, even when it's tough. Humility – We serve others confidently without arrogance or conceit. If you're looking for a place where your knowledge makes a difference, your contributions are recognized, and your career can continue to grow, we'd love to hear from you.