Workers Compensation - Technical Claims Specialist (Complex)
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.
This position may be filled as a Technical Claims Specialist I or a Technical Claims Specialist II. The salary range posted reflects the range for the varying pay scale.
GRS North America Claims is excited to announce our go forward strategy to provide employees with the flexibility to include an option to work from home full-time. Candidates who are selected for this position will be trained remotely and should reside within a reasonable commute of our Plano, TX or Tampa, FL hub offices to attend occasional collaborative activities with your team, as needed.
Candidates can also reside in the states of North Carolina or Oklahoma. The selected candidates in those states will be fully remote.
- 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 and MSA 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 Bachelors degree or equivalent business experience is required
- In addition, the candidate will generally posses 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
At Liberty Mutual, our purpose is to help people embrace today and confidently pursue tomorrow. That's why we provide an environment focused on openness, inclusion, trust and respect. Here, you'll discover our expansive range of roles, and a workplace where we aim to help turn your passion into a rewarding profession.
Liberty Mutual has proudly been recognized as a Great Place to Work by Great Place to Work US for the past several years. We were also selected as one of the 100 Best Places to Work in IT on IDG's Insider Pro and Computerworld's 2020 list. For many years running, we have been named by Forbes as one of America's Best Employers for Women and one of America's Best Employers for New Graduatesas well as one of America's Best Employers for Diversity. To learn more about our commitment to diversity and inclusion please visit: https://jobs.libertymutualgroup.com/diversity-inclusion
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. To learn more about our benefit offerings please visit: https://LMI.co/Benefits
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.