Senior Workers' Compensation Claims Specialist

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

Job summary

Liberty Mutual Insurance in California seeks a claims professional to investigate, evaluate and resolve high-exposure workers' compensation cases, applying medical management strategies and leveraging data to track trends. Responsibilities include reserving, settlement negotiation, collaboration with defense counsel, and training staff on complex exposures.

Requires California certification and 5-7 years' related experience; strong Excel/PowerPoint and communication skills.

Qualifications

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

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 and non‑complex staff.

Skills

Communication skills

Education

Bachelor’s degree or equivalent business experience

Tools

Excel

PowerPoint

Job description

Liberty Mutual Insurance in California seeks a claims professional to investigate, evaluate and resolve high-exposure workers' compensation cases, applying medical management strategies and leveraging data to track trends. Responsibilities include reserving, settlement negotiation, collaboration with defense counsel, and training staff on complex exposures.

Requires California certification and 5-7 years' related experience; strong Excel/PowerPoint and communication skills.