Claims Specialist II

Liberty Mutual Insurance • Boston, MA

11h

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 the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim’s management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.

Requirements

• Proven interpersonal, analytical and negotiation abilities required.
• Ability to provide information in a clear, concise manner, have attention to detail, excellent organizational skills, and ability to build effective relationships
• Bachelor`s degree or equivalent in addition to 1-years claiming handling experience. Knowledge of legal liability, insurance coverage and medical terminology preferred.
• High attention to detail: accurate data entry, thorough review of claim documentation, and careful reconciliation to minimize rework and denials.
• Licensing may be required in some states.

Nice To Haves

• Prior HMO RE/PEI claims adjudication preferred but not required
• Knowledge of CPT, HCPCS, and ICD coding is preferred

Responsibilities

• Manages an inventory of claims to evaluate compensability/liability.
• Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
• Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
• 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, refers claims to the subrogation group or Special Investigations Unit as appropriate.
• Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
• Performs other duties as assigned.

Benefits

• At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive.
• We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions.
• This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups.
• Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work.
• Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level