Claims Specialist, Workers' Compensation - 99510
Advance your career at Liberty Mutual Insurance - A Fortune 100 Company!
Review, analyze and process routine to moderately complex claims within assigned authority limits and consistent with policy and legal requirements to ensure the delivery of quality service to customers while protecting the assets of the company.
- Reviews and administratively sets-up claims in software tracking system and writes or revises the brief description of loss to ensure that it accurately reflects the actual circumstances.
- 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.
- Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and requests authorization to engage, independent adjusters, cause and origin experts and independent medical examiners.
- Determines and documents, during the investigation process, the potential for subrogation, identifying applicable tort feasors and promptly placing them 'on notice' of claim; refers claims to subrogation group upon recognition of potential recovery.
- Evaluates claims for potential fraud and makes referrals to the Special Investigations Unit as appropriate.
- Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
- Alerts underwriting, marketing and/or risk management regarding questionable risks encountered to ensure that potential hazards are clearly documented
NOTE: This is a range posting, the actual internal level/grade for this role will depend on the candidate's overall experience and skill level.
- BS/BA degree or equivalent work experience.
- Minimum of 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 (e.g., AEI, IIA, CPCU).
- Knowledge of claims investigation techniques, medical terminology and legal aspects of claims.
We value your hard work, integrity and commitment to positive change. In return for your service, it's our privilege to offer you benefits and rewards that support your life and well-being. To learn more about our benefit offerings please visit: https://LMI.co/Benefits
At Liberty Mutual, we give motivated, accomplished professionals the opportunity to help us redefine what insurance means; to work for a global leader with a deep sense of humanity and a focus on improving and protecting everyday lives. We create an inspired, collaborative environment, where people can take ownership of their work; push breakthrough ideas; and feel confident that their contributions will be valued and their growth championed.
We're dedicated to doing the right thing for our employees, because we know that their fulfillment and success leads us to great places. Life. Happiness. Innovation. Impact. Advancement. Whatever their pursuit, talented people find their path at Liberty Mutual.
Primary Location: United States-California-Rocklin
Education Level: Bachelor's Degree (±16 years)
Travel: Yes, 10 % of the Time
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