Remote Senior Long-Term Care Claims Strategist

Liberty Mutual Fire Insurance Co.; Weatogue (CT); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Liberty Mutual has an opening for a Complex Claims Specialist to join our Long-Term Care Claims Team. This is a high-visibility, hands-on role for an experienced Professional Liability claims handler with deep LTC facility expertise.

With minimal supervision, the Complex Claims Specialist will manage a book of specialty LTC Professional Liability Claims through the entire lifecycle, applying advanced coverage interpretation, clinical issue spotting, complex litigation management and prudent

Qualifications

• Bachelor's and/or advanced degree; J.D. is a plus.
• 7+ years claims/legal experience, with at least 2 years within a technical specialty.
• Healthcare claims experience strongly desired (Long-Term Care Professional Liability, Miscellaneous Medical Facilities and/or Group Practice claims).
• Advanced knowledge of claims handling concepts, practices and techniques, to include coverage issues and product line knowledge.
• Functional knowledge of law and insurance regulations in various jurisdictions.
• Demonstrated advanced verbal and written communications skills.
• Obtain and maintain Adjuster's license.

Responsibilities

• Own and manage LTC Professional Liability Claims from first notice through resolution: investigate, analyze coverage, evaluate liability and damages, establish and adjust reserves, negotiate settlements and close files within authority.
• Perform advanced coverage analysis (duty to defend vs. indemnify, occurrence vs. claims-made, allocation, additional insured issues, contractual liability, tail exposures, endorsements) and prepare clear coverage opinions and reservation of rights/declination communications.
• Document claims thoroughly using Claims Management System and proactively diary follow-up actions and deadlines.
• Set indemnity and expense reserves within authority; elevate and recommend reserves for matters outside authority; review reserves regularly and justify reserve positions to management and auditors.
• Manage litigation: retain and oversee outside defense counsel with LTC expertise, control budgets and billing, direct discovery strategy, and evaluate mediation/arbitration/trial risk to optimize resolution.
• Coordinate clinical resources and expert consultants (nursing, pharmacy, infection control, medical specialists) for chart review, causation analysis and expert testimony.
• Interface with regulatory, compliance and risk management teams on CMS/state surveys, licensing investigations and mandatory reporting; incorporate regulatory developments into case strategy.
• Collaborate with underwriting, reinsurance and subrogation on allocation, ceded reporting and recovery opportunities.
• Identify and report claim trends, coverage exposures and policy issues to management and underwriting; contribute to playbooks, training and process improvements.
• Participate in mediations and arbitrations within settlement authority and support major loss response efforts.
• Maintain required adjuster licenses and adhere to company litigation and billing guidelines.

Skills

Advanced claims handling

Analytical skills

Negotiation skills

Verbal & written communications

Adjuster licensure

Education

Bachelor's degree

J.D. or advanced degree (plus)

Tools

Claims Management System

Job description

Liberty Mutual has an opening for a Complex Claims Specialist to join our Long-Term Care Claims Team. This is a high-visibility, hands-on role for an experienced Professional Liability claims handler with deep LTC facility expertise.

With minimal supervision, the Complex Claims Specialist will manage a book of specialty LTC Professional Liability Claims through the entire lifecycle, applying advanced coverage interpretation, clinical issue spotting, complex litigation management and prudent