No-Fault PIP & Med-Pay Claims Specialist II

Liberty Mutual Insurance; Weatogue (CT); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Liberty Mutual is seeking a Claims Specialist to analyze PIP and Med-Pay No Fault claims within a hybrid work model. The role involves determining benefits, managing claims through resolution, and negotiating settlements with various parties.

The ideal candidate has 2+ years in claims, knowledge of investigation techniques, medical terminology, and applicable licenses. Training and certifications are encouraged as part of career growth at Liberty Mutual.

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, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
• Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
• Performs other duties as assigned.

Skills

Claims handling

Investigation techniques

Medical terminology

Legal aspects of claims

Education

BS/BA degree or equivalent

Job description

Liberty Mutual is seeking a Claims Specialist to analyze PIP and Med-Pay No Fault claims within a hybrid work model. The role involves determining benefits, managing claims through resolution, and negotiating settlements with various parties.

The ideal candidate has 2+ years in claims, knowledge of investigation techniques, medical terminology, and applicable licenses. Training and certifications are encouraged as part of career growth at Liberty Mutual.