Liberty Mutual Insurance ยท 1 day ago
Senior Claims Resolution Specialist, Small Commercial Complex Casualty
United States
Full-time
Remote
Senior Level
$73K/yr - $130K/yr
7+ years exp
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Responsibilities
Manages, investigates and evaluates coverage, liability, damages, in order to negotiate and settle the most severe and catastrophic injury and/or liability and coverage complexity claims within prescribed authority.
Using advanced negotiation skills, negotiates claims to fairly resolve pending inventory.
Plans and conducts detailed investigations to analyze and confirm coverage and to determine liability, compensability and damages of claims. Effectively utilizes tools to evaluate claims. Obtains detailed coverage and liability statements on complex claims. Determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners.
Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority. Succinctly and professionally present cases to senior leadership for reserves and evaluation authority as required by preset value ranges. Accountable for security of financial processing of claims, as well as security information contained in claims files.
Proficiently and proactively handle the claim file through various phases of litigation.
Independently review the applicability of coverage and civil law as well as local statutes. Recognize coverage issues and what policy language and facts should be considered. Attend mandatory and court ordered litigation events.
Communicates with various parties associated with the claim. Respond to written and verbal inquiries in a timely and professional manner, ensuring compliance within all company and statutory guidelines.
Prepare detailed and comprehensive initial reports and follow up reports with concise and effective action plans designed to move the claim towards resolution.
Identifies potential suspicious claims and refers to the Special Investigation Unit and identifies opportunities for third party subrogation. Keeps abreast of existing and proposed legislation, court decisions and trends and experience pertaining to coverage issues. May analyze the impact upon claims policies and procedures and advises Claims Management.
Participates in or leads special projects and mentors others. May assist with training.
Serve as the backup for the manager when needed, reviewing file reports, evaluations, reserve recommendations and authority requests. Assist with learning and development of less tenured adjusters in various legal, injury and venue specific arenas and serve as a mentor and subject matter expert in areas of specialty.
Acts as a liaison with various business partners.
Qualification
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Required
Expert knowledge of Small Commercial Complex claims investigation, coverage, reserving, expense management, resolution strategy, negotiation, litigation management, claims evaluation as well as the legal and regulatory environment
Excellent written and oral communications skills required as well as strong interpersonal, analytical, investigative and negotiation skills
Must be able to confidently and professionally handle conflict during negotiations while obtaining fair and reasonable outcomes
Must have superior customer service aptitude and work well with customers, vendors and agents of diverse backgrounds
Demonstrated ability to work independently, mentor other employees and serve as a subject matter expert
7 to 9 years of directly related experience required
Should actively pursue continuing education courses leading to industry certifications and participate in ongoing medical, legal and industry related trainings on an ongoing basis
Must maintain all applicable licenses
Preferred
Bachelor`s degree is preferred or equivalent work experience is required
Benefits
Annual Flexible Time Off (15 days)
Annual Flexible Time Off (20 days)
Company
Liberty Mutual Insurance
Liberty Mutual Insurance provides a broad range of insurance products and services.
10,001+ employees
H1B Sponsorship
Liberty Mutual Insurance has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (88)
2022 (141)
2021 (113)
2020 (88)
Funding
Current Stage
Late StageLeadership Team
David Long
CEO
Julie Haase
Executive Vice President and Chief Financial Officer
Recent News
2024-11-07
Coverager - Insurance news and insights
2024-03-13
Business Insider
2023-04-04
Company data provided by crunchbase
