Senior Workers' Compensation Claims Consultant

Job Description

Job Description

Why Join M&G:

OUR CULTURE!!

We Continue to Win Awards and Achieve Honors for our Culture, Industry Expertise, and Services

• Central Coast Best Places to Work by Pacific Coast Business Times (2018-2026)
• Best Agencies to Work for by Insurance Journal (2017-2019, 2021, 2024-2026)
• Big “I” Best Practices Agency by Independent Insurance Agents & Brokers of America (2016-2025)
• Top 100 P&C Agencies (2023-2026)
• MVP Account Managers (Insurance Journal)
• 50 Fastest Growing Companies by Pacific Coast Business Times (2017 – 2025)
• Diamond Level Family Friendly Workplace by SLO Chamber of Commerce (2022 – 2025)

Senior Workers' Compensation Claims Consultant

As part of a suite of value-added services we offer our clients, The Senior Workers’ Compensation Claims Consultant serves as a trusted technical resource and effective advocate for our Commercial clients. The role partners with our commercial clients as well as our internal Sale and Service teams, to improve claim outcomes, reduce total cost of risk, and support Agency retention and growth initiatives.

As a senior individual contributor and subject matter expert, the Senior Consultant applies their deep knowledge of California Workers’ Compensation system, analytical expertise, understanding of insurance carrier processes, and effective communication to enhance client satisfaction while positively influencing results. The Senior Workers’ Compensation Claims Consultant also plays an exciting role partnering with our Sales team to support new business development.

How You will be Compensated:

• $78,000-$98,000 Depending on Experience
• Medical, Dental, Vision Insurance plans. We cover 98% of the premiums for most individual plans
• Free Employee Assistance Program
• Paid Holidays, Paid Sick Time, and Flexible Vacation Time
• Paid Parental Benefits
• Disability and Life Insurance
• 401(k) with 50% match
• Flexible Spending Plan (FSA) and Health Savings Account (HSA)

What you Will Do:

• Claims Advocacy & Technical Expertise
  • Serves as the primary claims advocate for assigned clients, supporting effective and timely resolution of Workers’ Compensation claims.
  • Applies advanced working knowledge of the California Workers’ Compensation system, claims practices, and compliance requirements to support cost containment and client objectives.
  • Collaborates with insurance carriers, TPAs, defense counsel, and medical case managers to promote accuracy, accountability, and transparency in claims handling.
  • Reviews open and closed claims to identify trends, escalation concerns, and opportunities for improved outcomes.
  • Supports claims reviews, stewardship meetings, and client consultations with clear analysis and actionable recommendations.
• Data Analytics & Reporting
  • Analyzes claims data to identify frequency, severity, and loss drivers using Excel, Power BI, and other reporting tools.
  • Translates loss runs and claims data into client-ready summaries, dashboards, and visual reports.
  • Applies expertise in experience modification (X-Mod) calculations to provide education, conduct analysis and forecasting, and evaluate claim impacts.
  • Utilizes emerging analytical tools to improve insight, efficiency, and reporting quality.
• Client Engagement & Collaboration
  • Participates in client meetings, renewals, stewardship reviews, and prospect presentations alongside Risk Advisors and Account Management teams.
  • Builds and maintains strong client relationships through responsiveness, technical expertise, and a consultative communication style.
  • Provides clients with proactive education and guidance on claims management best practices and cost containment strategies.
  • Partners with internal and external Risk Control Consultants to align claims insights with safety initiatives and corrective actions.
  • Supports new business development and retention efforts through technical insight and client-facing contributions.
• Process Improvement & Knowledge Sharing
  • Identifies and recommends workflow, reporting, and process improvements within the Risk Management team.
  • Utilizes agency management system to maintain organized claims documentation and procedural resources.
  • Provides informal mentorship, training, and guidance to junior Risk Management staff related to claims analysis and best practices.
  • Remains current on legislative changes, market trends, and carrier practices affecting California Workers’ Compensation.

Who you Are:

• You have advanced knowledge of California Workers’ Compensation claims and industry practices.
• You apply your strong analytical and problem-solving skills, with the ability to translate findings into actionable recommendations.
• You have excellent verbal and written communication skills.
• You exhibit confidence and polish in client-facing environments.
• High exercise attention to detail, strong organizational skills, and sound independent judgment.
• You are proficient with Excel, including experience with claims dashboards and data visualization tools.
• You are proud of your professional, collaborative, and solutions-oriented approach.

Qualifications:

• Bachelor’s degree or equivalent professional experience
• 5+ years of experience in California Workers’ Compensation claims handling or analysis
• Experience working with multiple commercial carriers, TPAs, and insurance brokerages
• Valid California driver’s license with ability to travel locally
• Industry designations (WCCA, WCCP, or similar) a plus