Technical Claims Spec II, WC

Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics.

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.

• A bachelor's degree or equivalent business experience is required
• In addition, the candidate will generally possess 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 skill required

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.

As a purpose-driven organization, Liberty Mutual is committed to fostering an environment where employees from all backgrounds can build long and meaningful careers. Through strong relationships, comprehensive benefits and continuous learning opportunities, we seek to create an environment where employees can succeed, both professionally and personally.

At Liberty Mutual, we believe progress happens when people feel secure. By providing protection for the unexpected and delivering it with care, we help people embrace today and confidently pursue tomorrow.

We are dedicated to fostering an inclusive environment where employees from all backgrounds can build long and meaningful careers. By actively seeking employee feedback and amplifying the voices of our seven Employee Resource Groups (ERGs), which are open to all, we create an environment where every individual can make a meaningful impact so we continue to meet the evolving needs of our customers.

We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being.

Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.

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