Claims Adjuster I, Workers' Compensation

Liberty Mutual•Rocklin, CA

About The Position

The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from investigation through resolution. The role involves making decisions about liability and compensability, evaluating losses, and negotiating settlements. The position interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim management process. Training is provided, with an emphasis on enhancing skills needed to provide exceptional customer service.

Requirements

Proven interpersonal, analytical, and negotiation abilities.
Ability to provide information clearly and concisely.
Ability to build effective relationships.
Bachelor's degree or equivalent, in addition to one year of claims handling experience.
Licensing may be required in some states.

Nice To Haves

Knowledge of legal liability, insurance coverage, and medical terminology.

Responsibilities

Manage an inventory of claims and evaluate compensability and liability.
Establish an action plan based on case facts, best practices, protocols, regulatory issues, and available resources.
Plan and conduct investigations to confirm coverage and determine liability, compensability, and damages.
Assess policy coverage for submitted claims and notify the insured of any issues.
Determine and establish reserve requirements, adjusting reserves as necessary during claim processing.
Refer claims to the subrogation group or Special Investigations Unit as appropriate.
Assess actual damages associated with claims and negotiate settlements within assigned authority limits.
Perform other duties as assigned.