Complex Claims Consultant (Hybrid)
This role will support the Auto line of business. You will provide technical direction on complex claims, drives consistent, high-quality outcomes, and supports the development of others through coaching and guidance. You'll partner closely with claims leaders and cross-functional stakeholders to resolve challenging cases, identify trends, and recommend improvements to processes and best practices.
In this hybrid, you will be expected to work a minimum of 10 days per month from one of the following office locations: Madison, WI 53783; Boston, MA 02110; Denver, CO 80112; Keene, NH 03431; St. Joseph, MO 64507; Phoenix, AZ 85034.
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AmFam Group Office Locations:
Madison, WI 53783; Boston, MA 02110; Atlanta, GA metro area;
Denver, CO 80112; Hopkins, MN 55343; St.
Joseph, MO 64507; Phoenix, AZ 85034;
Internal candidates are encouraged to apply and should review the internal mobility guidelines in the hybrid policy reference guide for more information on potential relocation.
Position Compensation Range:
$99,000.00 - $167,000.00
Pay Rate Type:
Salary
Compensation may vary based on the job level and your geographic work location. Relocation support is offered for eligible candidates.
Primary Accountabilities
- Lead resolution strategy for complex/high-exposure claims , applying strong coverage analysis, investigation planning, and negotiation.
- Provide technical guidance and consultation to adjusters and leaders on challenging coverage, liability, damages, litigation, and compliance questions.
- Serve as an escalation point for complex matters; align stakeholders and drive timely, defensible decisions.
- Coach and mentor claim handlers; deliver feedback that improves technical skill, documentation quality, and customer outcomes.
- Identify trends, training needs, and process gaps; recommend enhancements to improve consistency, quality, and cycle time.
- Partner with Legal, SIU, Underwriting, and other teams as needed to support case strategy and risk mitigation.
- Model strong decision-making, communication, and customer-centered claim handling practices.
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Specialized Knowledge & Skills Requirements
- Demonstrated experience providing customer-driven solutions, support or service.
- Demonstrated ability to handle complex 1st and 3rd party, multi-line claims.
- Extensive problem-solving skill.
- Demonstrated experience with Quality Audit.
- Extensive knowledge of policies and endorsements coverages.
- Minimum of 7 years' experience handling complexity/high-severity claims with strong technical judgment.
- Strong working knowledge of claim best practices: investigation, coverage interpretation, documentation, evaluation, and negotiation.
- Direct leadership experience(coaching, mentoring, consultation, and stakeholder alignment).
- Excellent written and verbal communication; ability to translate complexity into clear recommendations.
- Experience developing training, job aids, or technical guidance for claim teams.
- Experience handling complex claims on the East or West Coast.
Travel Requirements
- Up to 10%.
- Catastrophe travel up to 75%.
Physical Requirements
- Work that primarily involves sitting/standing.
Additional Information
- Offer to selected candidate will be made contingent on the results of applicable background checks
- Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions
- Sponsorship will not be considered for this position unless specified in the posting
The candidate(s) selected for this role will be employed by AFICS, Inc. (American Family Insurance Claims Services, Inc.), an affiliate of American Family Mutual Insurance Company, S.I.
We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits.
We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.
American Family Insurance is committed to the full inclusion of all qualified individuals. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please email AskHR@AmFam.com to request a reasonable accommodation.
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Perks and Benefits
Health and Wellness
Parental Benefits
Work Flexibility
Office Life and Perks
Vacation and Time Off
Financial and Retirement
Professional Development
Diversity and Inclusion