Senior Complex Workers' Comp Claims Specialist

Liberty Mutual Fire Insurance Co.; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Liberty Mutual Fire Insurance Co. is seeking an experienced claims professional to manage Complex Workers' Compensation cases with high exposure.

Based primarily in Oregon, you will apply advanced medical management strategies and data-driven insights to evaluate, reserve, and resolve claims while coordinating with HO Examining and management. The role requires 5–7 years of claims experience (1–2 in complex claims), strong Excel/PowerPoint proficiency, and excellent written and verbal

Qualifications

• A bachelor’s degree or equivalent business experience is required.
• 5-7 years of related claims experience with 1-2 years of experience in complex claims.
• Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skills required.

Responsibilities

• Investigates claims to determine whether coverage is provided, establish compensability and verify exposure.
• Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority.
• Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management.
• Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols.
• Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely.
• Identifies and appropriately handles claims with third party subrogation potential, SIF (Self-Insured Fund) and MSA (Medicare Set Aside) exposure.
• Establishes and maintains accurate reserves on all assigned files.
• Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority.
• Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds.
• Demonstrates the ability to understand new and unique exposures and coverages.
• Demonstrates the ability to understand key data elements and claims related data analysis.
• Confers directly with policyholders on coverage and resolution strategy issues.
• Coordinates and participates in training sessions for less experienced staff, including both Complex Non-Complex staff.

Skills

Excel

PowerPoint

Communication

Education

Bachelor's degree or equivalent

Job description

Liberty Mutual Fire Insurance Co. is seeking an experienced claims professional to manage Complex Workers' Compensation cases with high exposure.

Based primarily in Oregon, you will apply advanced medical management strategies and data-driven insights to evaluate, reserve, and resolve claims while coordinating with HO Examining and management. The role requires 5–7 years of claims experience (1–2 in complex claims), strong Excel/PowerPoint proficiency, and excellent written and verbal