Complex Claims Specialist, Managed Care, E&O, D&O

Description Liberty Mutual has an immediate opening for a Complex Claims Specialist with Managed Care, Errors & Omissions (E&O) and Directors & Officers (D&O) Professional Liability claims experience. The Complex Claims Specialist, with minimal supervision, handles a book of specialty lines claims under E&O and D&O policies issued to health plans and other Managed Care Organizations throughout the entire claim's life cycle. In this role, you will be responsible for conducting investigations, evaluating coverage, setting adequate reserves, monitoring, documenting, and settling/closing claims in an expeditious and economical manner within prescribed authority limits for the line of business.

• This position may have an in-office requirement and other travel needs depending on candidate location. If you reside within 50 miles of one of the following offices, you will be required to go to the office twice a month: Boston, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; Westborough, MA; or Weatogue, CT. Please note this policy is subject to change.

Responsibilities

• Analyzes, investigates and evaluates the loss to determine coverage and claim disposition.
• Utilizes proprietary claims management system to document claims and to diary future events or follow up.
• Issue detailed coverage position letters for all new claims within prescribed time frames.
• Within prescribed settlement authority, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level.
• Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting.
• Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment.
• Pro-actively manages the case resolution process. Actively participates in mediations and arbitrations, as well as negotiation discussions within limit of settlement authority.
• Participates in the claims audit process.
• Provides claims marketing services by meeting with brokers and insureds.
• As required, maintains insurance adjuster licenses

Qualifications

• Bachelors' and/or advanced degree
• 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred (Managed Care, Errors & Omissions and Directors & Officers)
• Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge
• Functional knowledge of law and insurance regulations in various jurisdictions
• Demonstrated advanced verbal and written communications skills
• Demonstrated advanced analytical, decision making and negotiation skills

About Us

Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. 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 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. Fair Chance Notices

• California
• Los Angeles Incorporated
• Los Angeles Unincorporated
• Philadelphia
• San Francisco

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