Complex Claims Specialist, Miscellaneous Medical Facilities Professional Liability

Liberty Mutual•Weatogue, CT

5d•Hybrid

About The Position

Liberty Mutual is hiring an experienced Professional Liability claims handler to manage a book of specialty Miscellaneous Medical Facilities (MMF) Professional Liability claims through the full claim lifecycle. With minimal supervision, this high-visibility, hands-on role applies advanced coverage interpretation, clinical issue spotting, complex litigation management, and prudent reserving to resolve high-exposure matters economically and defensibly. Claims may involve ambulatory surgery centers, urgent care, behavioral health, home health, correctional medicine, or clinical staffing. The specialist may also shape claim strategy, coordinate clinical and expert resources, and serve as an internal subject-matter resource for underwriting, reinsurance, and senior leadership. The position may have in-office requirements and other travel needs depending on candidate location. Employees residing within 50 miles of Boston, Hoffman Estates, Indianapolis, Lake Oswego, Las Vegas, Plano, Suwanee, Chandler, or Westborough are required to work in an office twice a month. Candidates who do not live within 50 miles of one of those offices may be considered for remote work. This policy is subject to change. The position's salary range varies according to Liberty Mutual region, role level, location, and cost of labor. Starting salary is determined by factors including skills, experience, education, certifications, and location; compensation plans for some roles may include commission and/or bonuses. Liberty Mutual describes its workplace as inclusive and offers workplace flexibility, professional development opportunities, Employee Resource Groups, and benefits intended to support employees' lives and well-being.

Requirements

Bachelor's degree and/or advanced degree.
At least 7 years of claims or legal experience.
Advanced knowledge of claims-handling concepts, practices, and techniques, including coverage issues and product-line knowledge.
Functional knowledge of law and insurance regulations in various jurisdictions.
Advanced verbal and written communication skills.
Advanced analytical, decision-making, and negotiation skills.
Obtain and maintain an adjuster's license.

Nice To Haves

At least 2 years of experience within a technical specialty is preferred.
Medical malpractice claims experience is strongly desired.
J.D. is a plus.

Responsibilities

Manage Professional Liability claims from first notice through resolution, including investigation, coverage analysis, liability and damages evaluation, reserving, settlement negotiation, and file closure within authority.
Conduct advanced coverage analysis, including duty to defend versus indemnify, occurrence versus claims-made, allocation, additional insured issues, contractual liability, tail exposures, and endorsements; prepare coverage opinions and reservation-of-rights or declination communications.
Thoroughly document claims in the Claims Management System and proactively diary follow-up actions and deadlines.
Set indemnity and expense reserves within authority; escalate and recommend reserves outside authority; regularly review reserves and justify positions to management and auditors.
Manage litigation by retaining and overseeing outside defense counsel with long-term-care expertise, controlling budgets and billing, directing discovery strategy, and assessing mediation, arbitration, and trial risks.
Coordinate clinical resources and expert consultants, including nursing, pharmacy, infection control, and medical specialists, for chart review, causation analysis, and expert testimony.
Collaborate with underwriting, reinsurance, and subrogation on allocation, ceded reporting, and recovery opportunities.
Identify and report claim trends, coverage exposures, and policy issues to management and underwriting; contribute to playbooks, training, and process improvements.
Participate in mediations and arbitrations within settlement authority and support major loss response efforts.
Maintain required adjuster licenses and follow company litigation and billing guidelines.