Key Responsibilities and Required Skills for National Claims Technical Advisor

🎯 Role Definition

The National Claims Technical Advisor is a senior subject-matter expert who provides national technical leadership across complex and high-severity claims (property, casualty, specialty lines). This role delivers authoritative technical guidance to adjusters, managers, underwriting, legal and brokers; leads national large-loss and catastrophe response; standardizes best practices and protocols; and drives claim outcome consistency, cost containment and regulatory compliance. The advisor leverages deep claims technical knowledge, data-driven insights and strong stakeholder management to reduce volatility, protect brand reputation and improve loss ratios.

📈 Career Progression

Typical Career Path

Entry Point From:

Senior Claims Adjuster — Complex/Large Loss specialist
Regional Claims Technical Lead / Field Technical Adjuster
Claims Litigation or Major Loss Manager

Advancement To:

National Claims Director / Head of Claims Technical
Chief Claims Officer / Vice President, Claims
Head of Loss Containment or Risk Management

Lateral Moves:

Product / Underwriting Technical Liaison
Catastrophe Response Lead
Claims Operations or Systems Lead

Core Responsibilities

Primary Functions

Act as the national technical authority on complex third-party liability and first-party property claims, providing detailed written and verbal guidance to adjusters, claim managers, and senior leaders on exposure assessment, technical strategy and settlement approach.
Lead the technical response for major losses and catastrophe (CAT) events, coordinating cross-functional teams (field adjusters, estimators, engineers, forensic experts, legal and reinsurance) to establish triage, priority workflows and national deployment of resources.
Review, audit and provide technical sign-off on large-loss files (including multi-million dollar property losses, commercial liability, environmental and construction defect claims), ensuring reserves are adequate and supported by technical justification.
Develop, maintain and disseminate national technical standards, claim-handling protocols, repair vs replace decision frameworks, scope validation processes and catastrophic response playbooks to ensure consistent handling across regions.
Provide technical direction for complex coverage and causation questions in conjunction with legal counsel, including drafting position statements, coverage analyses and preparing technical exhibits for litigation or mediation.
Serve as the primary technical liaison with reinsurers, brokers and major clients on loss development, reserving impacts and claims strategy for high-severity cases, including preparation for quarterly reinsurance reviews and loss runs.
Mentor and coach senior adjusters and regional technical leads through case consultations, file reviews and targeted training to elevate technical competency and improve key performance indicators (severity, cycle time, litigation penetration).
Manage vendor relationships for engineering, building consultants, appraisers, forensic accountants and subrogation specialists; negotiate scopes of work and fees, and ensure vendor deliverables meet program quality standards.
Conduct on-site technical inspections for complex commercial property and casualty losses; coordinate forensic investigations, evidence preservation and multi-disciplinary technical assessments to determine cause, origin and extent of damage.
Collaborate with Claims Operations and IT to optimize claims systems (e.g., Guidewire ClaimCenter or equivalent), workflow automation, technical coding, and configuration to embed national standards and improve data capture accuracy.
Lead post-event technical reviews and root-cause analyses to identify systemic issues, process gaps and opportunities for improvements that reduce frequency and severity of future losses.
Provide expert support for litigation and trial preparation, including identifying expert witnesses, compiling technical exhibits, and delivering subject matter expert testimony when required.
Oversee technical reserve reviews and recommended adjustments, working with actuarial and reserving teams to align technical rationale with loss development patterns and financial reporting requirements.
Drive analytics and KPI reporting related to large losses, average severity by peril, vendor performance, and technical cause codes; use insights to influence national strategy and underwriting feedback.
Design and deliver national technical training curriculum for claims staff and managers on topics such as complex property forensic analysis, commercial liability technical triage, contract interpretation, and best practices in documentation.
Represent the claims organization on multi-disciplinary product, underwriting and pricing committees to provide technical perspective on policy wordings, emerging perils and coverage risk management.
Implement quality assurance and peer review programs for high-severity claims to ensure compliance, control, consistent decisioning and defensible reserving.
Lead or participate in cross-functional initiatives to quantify and escalate major claim exposures (emerging trends, class action risks, punitive damage potential) and recommend mitigation strategies.
Manage escalation and communications on politically sensitive or high-profile claims, developing stakeholder briefings, executive summaries and client-facing technical reports.
Champion continuous improvement projects — including standardization of technical templates, digitization of evidence capture, and testing of new estimation technologies — to improve accuracy and cycle-time on complex claims.
Coordinate subrogation and recovery strategies for complex losses; provide technical attestations and direction that support recoveries and reduce net claims cost.
Monitor and ensure compliance with state and federal regulatory requirements, industry guidance and internal governance standards as they relate to claims handling, privacy, and consumer communications.
Provide national oversight of catastrophe modelling outputs, field estimates and claims data feeds to reconcile model expectations with actual loss development and inform future catastrophe preparedness.

Secondary Functions

Provide ad-hoc technical subject-matter-expert contributions to analytics and “deep-dive” reviews requested by senior leadership.
Collaborate with data science and BI teams to translate technical claims requirements into actionable reporting and dashboards.
Participate in the selection, testing and rollout of new claims technology modules to ensure technical workflows and validation rules align with best practice.
Support commercial negotiations with vendors and third-party administrators to improve technical service delivery and drive cost efficiencies.
Contribute to knowledge management by authoring technical guidance notes, FAQ libraries and field reference tools for claim teams.
Assist HR and recruiting in defining technical role competencies and interview guides for senior technical claims hires.
Occasional travel to major loss sites, vendor facilities, or client meetings to support technical investigations and stakeholder relations.
Act as a backup decision authority for escalated claims decisions when regional managers are unavailable.

Required Skills & Competencies

Hard Skills (Technical)

Deep technical knowledge in property & casualty claim handling (commercial property, business interruption, builders risk, general liability, environmental claims).
Large-loss and catastrophe claims management experience, including triage, mobilization and national-scale coordination.
Reserve analysis and technical reserve setting for complex and long-tail claims.
Experience supporting claims litigation, expert witness preparation and working with outside counsel.
Familiarity with claims systems such as Guidewire ClaimCenter, Duck Creek or equivalent; ability to translate technical workflows into system requirements.
Advanced proficiency in Microsoft Excel (pivot tables, model building), plus experience with SQL for data interrogation and Power BI/Tableau for dashboards.
Understanding of forensic investigation methods (structural engineering, cause & origin, mechanical/electrical forensic analysis).
Knowledge of insurance policy wordings, coverage interpretation, indemnity limits and reinsurance structures.
Experience managing third-party vendor panels (engineers, appraisers, restoration contractors) and negotiating scopes of work.
Competence with CAT modelling outputs and familiarity with industry vendors (RMS, AIR, Karen Clark) a plus.
Working knowledge of regulatory requirements and compliance standards affecting claims (state-specific statutes, bad faith exposure, privacy rules).
Project management skills, including experience running cross-functional initiatives and implementing process standardization.

Soft Skills

Strong executive presence with the ability to explain complex technical issues in concise business terms for CFOs, underwriters and boards.
Excellent written communication — capable of drafting technical position papers, executive summaries and clear file documentation.
Influential leadership and stakeholder management; able to drive change across regional teams and matrixed organizations.
Critical thinking and structured problem solving to assess ambiguous, multi-factor loss situations.
High emotional intelligence, able to coach, mentor and de-escalate sensitive claimant or client interactions.
Strong negotiation skills for vendor agreements, subrogation recoveries and claims settlements.
Resilient under pressure; effective during CAT surge and high-volume major loss events.
Collaborative mindset with the ability to build trusted relationships across claims, underwriting, legal, actuarial and operations.
Attention to detail and a strong compliance orientation to maintain defensible file documentation and audit readiness.
Coaching and training aptitude to uplift technical capability across national teams.

Education & Experience

Educational Background

Minimum Education:

Bachelor's degree in Risk Management, Insurance, Business, Finance, Engineering, Construction Management, or related field.

Preferred Education:

Bachelor's plus advanced credentials (CPCU, ARM, AIC/CIC, FCIP, or equivalent); Master's degree in Risk Management, Business Administration (MBA) or Engineering is advantageous.
Technical certifications related to construction, engineering, or forensic investigation are a plus.

Relevant Fields of Study:

Risk Management & Insurance
Construction / Structural Engineering
Business Administration / Finance
Legal Studies (for coverage and litigation interface)

Experience Requirements

Typical Experience Range: 8–15+ years of claims experience with progressive responsibility, including 4+ years handling large-loss or national claims advisory duties.

Preferred:

10+ years in property & casualty claims with demonstrable experience in large-loss adjusting, catastrophe management and technical leadership.
Prior experience in a national technical advisory or centralized escalation role, managing complex files, vendors and cross-functional stakeholders.
Proven track record of improving claims outcomes through technical program design, quality assurance and systems enablement.