Our Claims team is currently seeking a Technical Claims Consultant, with expertise in Commercial General Liability (CGL). This is a full-time, exempt role with a hybrid work schedule (two days in the office) at one of our Hanover offices: Worcester, MAHowell, MIRichmond, VAItasca, ILSyracuse, NY Phoenix, AZAlpharetta, GARocky Hill, CT
Position Overview/Summary:
The Technical Consultant, Casualty Claims, manages moderate to complex and high-value casualty and litigated claims with minimal supervision. 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.
Responsibilities/Essential Functions:
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
Essential Skills and Experience:- 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.
Physical Demands and Work Environment:
Ability to use a personal computer and other standard office equipment. Ability to sit and/or stand for extended periods. Required to work on-site as needed. Ability to travel as necessary. Ability to work in a fast paced, changing or stressful environment. Ability to perform work in a noisy/loud work environment. May be required to have and maintain sufficient home-based internet connection. JobFamilyClaims - Adjusting JobFunctionClaimsPayTypeSalaryHiringMinRate80000HiringMaxRate100000
