Senior Claims Specialist I, Workers' Compensation

Liberty Mutual•Hoffman Estates, IL

27d

About The Position

The Senior Claims Specialist works within a Claims Team, using technology to review, analyze, and process claims that are routinely moderately complex to complex within assigned authority limits. The role involves making decisions about liability and compensability, evaluating losses, negotiating settlements, and managing an inventory of commercial property/casualty claims involving bodily injury or property loss. The specialist may also help the Claims Team Manager assign new claims, provide technical direction, and monitor caseloads. The role serves as a senior technical professional on the team, assisting colleagues with escalated issues and mentoring and training new team members. It also participates in quality review and other claim-related proceedings and reviews. Other duties may be assigned.

Requirements

Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations.
Leadership ability and demonstrated time-management skills to delegate work appropriately and organize resources effectively.
Advanced knowledge of claims case-handling practices, legal liability, general insurance policy coverage, and state tort laws, normally acquired through a bachelor's degree or equivalent training plus 3 to 5 years of directly related work experience.
Obtain and maintain all applicable licenses.

Responsibilities

Plan and conduct claim investigations, including interviewing insureds, witnesses, and claimants; collecting and evaluating documentation; and securing evidence while protecting chain of custody.
Analyze and confirm coverage and determine liability, compensability, and damages.
Determine when independent adjusters, cause-and-origin experts, or independent medical examiners are needed and engage them as appropriate.
Refer claims to the subrogation group or Special Investigations Unit when appropriate.
Assess policy coverage for submitted claims and notify insureds of any coverage issues.
Determine reserve requirements and adjust reserves as needed during claim processing.
Assess actual damages and negotiate settlements within assigned authority limits.
Coordinate litigation activities for assigned claims to support timely and cost-effective resolution, and attend trials as a company representative.
Assist team members with escalated issues as a senior technical professional.
Mentor and train new team members.
Participate in the Quality Review process.
Participate in Suit Committees, Roundtables, Arbitrations, Mediations, and field investigations, and may assist with closed-file reviews.
Assist the Claims Team Manager with assigning new claims, providing technical direction, and monitoring caseloads.
Perform other duties as assigned.