Catastrophe Claims Vendor Management Consultant II

In This Role, You Will:

This role is part of the Vendor Oversight Team (VOT) and, under limited supervision, is responsible for monitoring, directing, and providing oversight on claims handled by contingent worker adjusters, from the initial report to final resolution. Responsibilities include:

• Guiding adjusters through investigations and assessing coverage, liability, and damages.
• Reviewing claim values and authorizing settlements or denials for moderate losses exceeding adjuster or contingent worker manager authority.
• Supporting adjusters and managers to enhance customer service and contribute to process improvements.
• Providing oversight that ensures quality performance, expert execution of claim processes, and a productive, supportive work environment.
• Analyzing trends and identifying opportunities, participating in action planning for adjusters and management.
• Providing work guidance, mentoring, and coaching to less experienced employees.
• Delivering fast, fair, and easy service to support customer retention.
• Independently prioritizing responsibilities and managing workload.
• Consistently meeting performance expectations in behavior, production, quality, and customer service.

This position is located within the Mobile Inside VOT Operation.

You’re a Great Match for This Role If You Have:

Customer Service

• Builds and maintains a strong customer connection by understanding and addressing their needs.
• Serves customers with empathy, ensuring their concerns are met.
• Researches and resolves complex customer communications, concerns, conflicts, or issues.
• Oversees contingent worker involvement to bring complex claims to resolution.
• Reviews customer satisfaction results and helps develop action plans for improvement.

File Documentation & Reporting

• Summarizes documents and updates claim system notes.
• Documents claims with evaluations, decision-making processes, and justifications.

Vendor File Review & Quality Assurance

• Conducts claims performance, quality, and audit reviews.
• Schedules and performs ride-alongs and sit-alongs for vendor evaluations.
• Provides direction, evaluations, and recommendations in claim files.
• Communicates audit findings and process improvement recommendations to claims management.
• Supports AOR/MCO in achieving customer service goals.
• Reviews statistical reports to assess claim performance and processes, offering insights based on analysis.
• Assists management in identifying and addressing complex claim handling challenges through quality reviews and data analysis.
• Supports action plan execution and participates in internal/external calibrations.

CAT Claims Handling Support

• Monitors AOR segments to ensure timely and quality claim handling.
• Acts as a resource for contingent worker adjusters on complex claims.
• Provides expertise on all aspects of claims, including:
  • Investigations
  • Coverage decisions
  • Evaluations
  • Estimating
  • Documentation
  • Customer communication
  • Compliance
  • Settlements and denials
• Supports and manages claims involving:
  • Coverage investigations
  • Supplement triage
  • Subrogation investigations
  • Public Adjuster claims
  • ALE handling
  • Asbestos abatement
  • OA ladder assists
  • Contents inventory and pricing
• Executes complex event strategies.
• Oversees engineering, condo claims, and cause-and-origin investigations.
• Manages vendor oversight and contingent workforce performance.
• Verifies staffing levels to meet demand.
• Reviews damage estimates and approves payments for moderately complex claims.
• Coordinates large loss process.

Training – Development & Delivery

• Identifies technical training opportunities and assesses adjuster development needs.
• Provides coaching and training recommendations to contingent worker adjusters and managers.
• Serves as a resource on complex claim and coverage matters.
• Assists in developing and delivering training materials.
• Facilitates formal claim training, mentoring, and feedback sessions.

Other Projects & Responsibilities

• May lead or participate in special projects.
• May serve as a team lead for medium-sized projects or team member on larger initiatives.

Functional Skills

• Preferred: Bachelor’s degree or equivalent experience.
• Preferred: 3 years Property experience.
• Proficiency in current property estimating software.
• Strong customer interaction skills with an emphasis on empathy.
• Broad knowledge of:
  • Insurance policies, coverage, and regulations.
  • Claims processes, policies, procedures, and compliance standards.
  • Data analysis techniques to assess trends and drive improvements.
  • Negotiation and arbitration skills.
  • Training facilitation and coaching techniques.
• Problem-solving and conflict resolution skills.
• Ability to investigate, evaluate, and settle complex claims.
• Independent decision-making within authority limits.
• Maintains all necessary licenses and registrations as required by state laws.
• Regular, predictable attendance is an essential function of this job.

Travel

• Potential travel: 10–25% annually, depending on operational needs and CAT events.

Schedule & Hiring Locations

• Work Schedule: 10 days on, 4 days off, 7 AM – 7 PM.
• Location: Fully Remote.
• Not Eligible for Residents of: California, Alaska, Hawaii, Washington, or Puerto Rico.

Notice of Licensing Requirement

• As a condition of employment, some locations may require an adjuster and/or appraiser license, which includes passing an additional Department of Labor background check.
• If required, licenses must be obtained within 60 days of hire.

Notes

• The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job.

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