Lead Complex Workers’ Comp Claims Specialist (CA)

Liberty Mutual Insurance; Roseville (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Liberty Mutual Insurance in California handles complex workers’ compensation claims with a focus on high exposure cases. Investigates coverage, compensability, and exposure while coordinating with management and defense counsel.

The role requires a strong background in claims handling, data analysis, and collaboration across teams to resolve high‑value matters and improve outcomes for insureds and the company.

Qualifications

• Bachelor’s degree or equivalent business experience required.
• 5–7 years of related claims experience with 1–2 years in complex claims.
• Proficiency in Excel and PowerPoint; excellent written and verbal communication skills.

Responsibilities

• Investigates claims to determine coverage and compensability.
• Resolves claims within authority and advises on cases exceeding authority.
• Participates in pricing, reserving, and strategy discussions with management.
• Works with staff and defense counsel on litigated files per protocols.
• Identifies suspicious claims and potential for adverse development.
• Handles third‑party subrogation, SIF, and Medicare Set Aside exposure as applicable.
• Maintains accurate reserves on all files and makes timely recommendations.
• Prepares for and participates in mediation or settlement conferences.
• Communicates with policyholders regarding coverage and resolution strategy.
• Trains less experienced staff on complex and non‑complex cases.

Skills

Excel

PowerPoint

Communication skills

Education

Bachelor’s degree or equivalent business experience

Job description

Liberty Mutual Insurance in California handles complex workers’ compensation claims with a focus on high exposure cases. Investigates coverage, compensability, and exposure while coordinating with management and defense counsel.

The role requires a strong background in claims handling, data analysis, and collaboration across teams to resolve high‑value matters and improve outcomes for insureds and the company.