PIP & Med-Pay No-Fault Claims Specialist II

Liberty Mutual Fire Insurance Co.; Westborough (MA); Hybrid; USD 61,000 - 113,000; Full time

Benefits offered by this job

Flexible Time Off (15 days)

Job summary

Liberty Mutual Fire Insurance Co. is seeking a Commercial No Fault PIP/Med Pay Adjuster - Claims Specialist II in a hybrid role. The position manages complex PIP/Med-Pay claims, decides coverage and eligibility, and handles high-exposure cases within a team using latest technology.

You will interact with claimants, providers, attorneys and others to resolve claims. The job requires a BS/BA or equivalent, at least 2 years in claims, and licenses with ongoing education (AEI/IIA/CPCU preferred).

Qualifications

• BS/BA degree or equivalent work experience.
• Minimum 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 (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 conducts 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 and negotiates settlements within assigned authority limits.
• Performs other duties as assigned.

Skills

Claims experience

Medical terminology

Legal aspects

Licenses

Industry certifications (AEI/IIA/CPCU)

Education

BS/BA degree or equivalent

Job description

Liberty Mutual Fire Insurance Co. is seeking a Commercial No Fault PIP/Med Pay Adjuster - Claims Specialist II in a hybrid role. The position manages complex PIP/Med-Pay claims, decides coverage and eligibility, and handles high-exposure cases within a team using latest technology.

You will interact with claimants, providers, attorneys and others to resolve claims. The job requires a BS/BA or equivalent, at least 2 years in claims, and licenses with ongoing education (AEI/IIA/CPCU preferred).