Senior Claims Resolution Specialist, Small Commercial Complex Casualty

Pay Philosophy

The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.

Description

Our Small Commercial Complex Casualty team is currently hiring for Senior Claims Resolution Specialists who will efficiently and independently manage small commercial claims that present the highest complexity, exposure and/or complex coverage or liability issues. In this role, you will determine coverage, liability, set and adjust reserves, evaluate the claim, manage the litigation and negotiate settlements. You will work within prescribed authority limits handling claims and investigate and determine liability of all parties involved. Also, you will ensure delivery of high-quality customer service to protect our insured, and assets of the company. And of course, demonstrate the highest level of expertise and sound judgment in complex matters; often serves as a subject matter expert.

 

 

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.

Qualifications

• 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
• Bachelor`s degree is preferred or equivalen