Senior Claims Consultant
Squaremouth Inc
Senior Claims Consultant
The Senior Claims Consultant, in a client-facing role, applies their experience in providing interpretation of policy language, coverage analysis, advocacy, coverage and dispute resolution. Will act as a liaison between clients, adjusters, defense counsel, insurance companies, claims management and other related client services. Provides professional, courteous service to our clients, carrier representatives, underwriters, business partners, and HUB colleagues, resulting in outcomes that meet or exceed expectations. Provides a high level of claims support to Producers and Account Managers to support client retention and growth as appropriate and in accordance with standard practices, policies, and procedures.
Essential Duties and Responsibilities
- Serve as the client's primary advocate with carriers, adjusters, TPAs, and defense counsel throughout the life cycle of claims
- Consultation with clients on claims issues
- Review and recommend solutions to coverage, quantum, and claim handling management issues
- Negotiate with insurers, adjusters and defense counsel to expedite and obtain fair settlement of claims
- Participate in sales presentations to prospective clients
- Assist the client in preparing special claims servicing instructions, focusing on the client's specific needs and taking into consideration the structure of their insurance programs
- Review and comment on policy wording for account teams
- Review of claims with clients/insurers/loss adjusters regularly
- Work with clients to ensure efficient, prompt and smooth flow of claims handling and established processes are followed
- Provide guidance to client as to claim process along with direction regarding likely outcome and timelines
- Liaise with carriers and representatives throughout the claim process
- Appropriately document conversations with clients and carrier representatives and update all HUB computer systems and agency management systems when necessary
- Ensure the accuracy of data in those systems
- Answer basic coverage questions
- Review and interpret policy language with the ability to propose coverage solutions in questionable/disputed situations
- Accurate electronic filing of claims, as appropriate
- Attend Critical Path, prospecting, stewardship and client meetings as requested, including participation in presentations
- Works closely with Producers and other HUB personnel on claim matters for our clients, while adhering to HUB's best practices and standard procedures
- Stays abreast of changes in the insurance industry and other external conditions that may impact their clients
- Travels on company business as required
- Prepares reports for management as required
- Attends industry related continuing education training and courses.
- Performs other duties and projects as assigned
Work Experience Requirements
- 5+ years of commercial insurance claims experience, with a strong emphasis on client-side advocacy and carrier dispute resolution in an agency or broker firm
- Demonstrated ability to challenge carrier coverage denials, reservation of rights letters, and adverse coverage positions across property, CGL, and specialty lines
- Track record of achieving favorable coverage outcomes on complex claims through persistent advocacy, policy analysis, and strategic engagement with carriers and TPAs
- Proven ability to work independently and collaboratively with a team
- Strong analytical skills with the ability to identify coverage arguments, policy ambiguities, and contractual protections that support client recovery
- Excellent oral & written communication skills, with the ability to clearly articulate coverage positions, challenge carrier arguments, and guide clients through complex claims
- Proficiency with all MS Office Applications and claims management systems
- Occasional travel
Education Requirements
- Bachelor's Degree Preferred
Licensing or Certification Requirements
- Relevant Insurance licenses per state/regional statutes
- Associate in Claims (AIC) or CPCU designation preferred
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