Technical Claims Specialist, Workers Compensation

Description Under limited supervision, responsible for the investigation, evaluation, and disposition of complex workers compensation cases with high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures, and is cognizant of new industry trends and claim handling techniques. Uses available data to track claims trends and other claim related metrics. Key Requirements NV Workers’ Compensation Claims Experience required. NV residence is also preferred, but not required. Responsibilities Investigates claims to determine coverage, establish compensability, and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely. Identifies and appropriately handles claims with third party subrogation potential, SIF and MSA exposure. Establishes and maintains accurate reserves on all assigned files. Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority. Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds. Demonstrates the ability to understand new and unique exposures and coverages. Demonstrates the ability to understand key data elements and claims related data analysis. Confers directly with policyholders on coverage and resolution strategy issues. Coordinates and participates in training sessions for less experienced staff, including both Complex and non-Complex staff. Qualifications Bachelor’s degree or equivalent business experience. 5-7 years of related claims experience with 1-2 years of experience in complex claims. Demonstrated proficiency in Excel, PowerPoint and excellent written and verbal communication skills. Equal Employment Opportunity 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. California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco #J-18808-Ljbffr