Hybrid PIP & Med-Pay Claims Specialist

Liberty Mutual Insurance

Boston (MA)

Hybrid

USD 60,000 - 75,000

Full time

4 days ago

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Job summary

Liberty Mutual Insurance is seeking a Claims Specialist to analyze complex Personal Injury Protection (PIP) and Medical Payment (Med-Pay) No Fault claims. You’ll manage a caseload from investigation through resolution, determine coverage and eligibility, and negotiate settlements with claimants, policyholders, and providers.

The role requires a BS/BA or equivalent experience, 2+ years in claims, and licensure.

Qualifications

BS/BA degree or equivalent work experience.
Minimum of 2 years’ experience in claims adjustment, general insurance or formal claims training.
Required to obtain and maintain all applicable licenses.
Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU).
Knowledge of claims investigation techniques, medical terminology and legal aspects of claims.

Responsibilities

Manages an inventory of claims.
Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
Plans and conduct investigations of claims to confirm coverage and eligibility to medically manage the claims through resolution.
Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves as necessary.
Assesses actual damages and negotiates settlements within authority limits.
Performs other duties as assigned.