Client Claims Consultant

JOB DESCRIPTION

Job Summary

The Benefits Consultant serves as a "single point of contact" for the relationship management team, clients, and brokers of specific large and national account clients and groups.

Key relationship builder and strategic partner, aiding in enhancing the client experience and building trust.

This role will act as the day-to-day contact to handle inquiries, resolve issues, escalations, and be a subject matter expert on claims.

Responsible for reporting and trend analysis, as well as client education on claim processes.

Will partner internally and externally to research and resolve client-raised issues, while identifying root causes of reoccurring issues and recommendations for process improvements.

Additionally, the Benefits Consultant will develop and facilitate client and field facing claims training, educational materials, along with ad hoc support navigating claims.

This is a full-time, in person role at either of the locations below:


* Portland, ME


* Chattanooga, TN


* Columbia, SC


* Chicago, IL

Responsibilities


* Act as the primary claims resource for national specialty group accounts, addressing escalated or complex claims inquiries from both internal staff and external clients.


* Partner with field sales, account management, and underwriting teams to resolve claims issues efficiently and accurately.


* Provide proactive claims education, training, and support to field and client teams.


* Analyze claims trends, identify root causes of recurring issues, and recommend process improvements.


* Liaise with Legal, Compliance, and Product teams to interpret policy language and ensure claims are handled in accordance with regulatory and contractual requirements.


* Represent the claims department in client meetings, presentations, and audits as needed.


* Maintain up-to-date knowledge of industry best practices, regulatory changes, and specialty group needs.


* Proven expertise in claims management with a strong commitment to customer service.


* Advanced analytical abilities, keen attention to detail, sound judgment, and critical thinking skills.


* Outstanding written and verbal communication skills, including the capability to create and deliver presentations to clients.


* Effective collaboration, strong problem-solving abilities, and demonstrated teamwork.


* Creative thinking and problem-solving skills, with the ability to evaluate options, identify alternatives, and drive solutions.


* Ability to work autonomously and thrive in uncertain or minimally guided situations.


* Strong analytical skills, including the capacity to generate reliable reports and documentation across various topics.


* Excellent organizational skills, adept at multitasking in a fast-paced environment, maintaining attention to detail, and prioritizing tasks.


* Results-oriented mindset with a dedication to continuous improvement.

Skills


* Proven e...