Senior Claims Resolution Specialist, Complex Casualty

Location
Lake Mary, Florida
Salary
Not Specified
Posted
Aug 05, 2022
Closes
Oct 03, 2022
Ref
6717977#GIJtoGJS.1
Industry
Insurance
Category
Insurance

This position will handle Auto and Homeowner's Complex Casualty Claims for the Southeast Region.

The Complex Casualty Claims Resolution specialist independently or with minimal direction manages claims that present high exposure and/or complex coverage or liability issues for auto and homeowners claims. Determines coverage, liability, sets and adjusts reserves, evaluates the claim, manages the litigation and negotiates settlements. Works within prescribed authority limits handling claims. Investigate and determine liability of all parties involved. Ensures delivery of high quality customer service to protect our insured, and assets of the company. Demonstrates a high level of expertise and sound judgment in complex matters; may serve as a subject matter expert. 

Candidates residing outside the Southeast region will be considered, however, the ideal candidate will possess jurisdictional experience within the Southeast territories and reside in Central or Eastern time zones.  The salary guide posted reflects a range of remote locations and experience.

This position is eligible for up to a $2,500 sign on bonus for external candidates with an active adjuster's license (will need to provide documentation of active license).

Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. 

Responsibilities:

  • Manages, investigates and evaluates coverage, liability, damages, in order to negotiate and settle severe and catastrophic injury and/or liability and coverage complexity claims within prescribed authority.
  • Confidently negotiate claims to fairly resolve pending inventory.
  • Plans and conducts detailed investigations to analyze and confirm coverage and to determine liability, compensability and damages of claims.
  • Effectively utilizes tools to evaluate claims. Obtains detailed coverage and liability statements on complex claims.
  • Determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners.
  • Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority. Succinctly and professionally present cases to senior leadership for reserves and evaluation authority as required by preset value ranges.
  • Accountable for security of financial processing of claims, as well as security information contained in claims files.
  • Proficiently and proactively handle the claim file through various phases of litigation. Independently review the applicability of coverage and civil law as well as local statutes.
  • Recognize coverage issues and what policy language and facts should be considered. Attend mandatory and court ordered litigation events.
  • Communicates with various parties associated with the claim. Respond to written and verbal inquiries in a timely and professional manner, ensuring compliance within all company and statutory guidelines.
  • Prepare detailed and comprehensive initial reports and follow up reports with concise and effective action plans designed to move the claim towards resolution.
  • Identifies potential suspicious claims and refers to the Special Investigation Unit and identifies opportunities for third party subrogation.
  • Keeps abreast of existing and proposed legislation, court decisions and trends and experience pertaining to coverage issues.
  • May analyze the impact upon claims policies and procedures and advises Claims Management.Participates in or leads special projects and mentors others, as needed.
  • May serve as the backup for the manager when needed, reviewing file reports, evaluations, reserve recommendations and authority requests.
  • Assist with learning and development of less tenured adjusters in various legal, injury and venue specific arenas.
  • Acts as a liaison with various business partners. 
  • Advanced knowledge of claims investigation, coverage, reserving, expense management, resolution strategy, negotiation, litigation management, as well as the legal and regulatory environment.
  • Must have superior customer service aptitude and work well with customers, vendors and agents of diverse backgrounds.
  • Excellent written and oral communications skills required as well as strong interpersonal, analytical, organizational, investigative and negotiation skills.
  • Must be able to confidently and professionally handle conflict during negotiations while obtaining fair and reasonable outcomes.
  • Demonstrated ability to work independently, achieve results and execute.
  • Bachelor`s degree is preferred or equivalent work experience is required. 5 to 7 years of directly related experience required.
  • Should actively pursue continuing education courses leading to industry certifications and participate in ongoing industry related trainings on an ongoing basis.
  • Must maintain all applicable licenses. 

At Liberty Mutual, our purpose is to help people embrace today and confidently pursue tomorrow. That's why we provide an environment focused on openness, inclusion, trust and respect. Here, you'll discover our expansive range of roles, and a workplace where we aim to help turn your passion into a rewarding profession.

Liberty Mutual has proudly been recognized as a Great Place to Work by Great Place to Work® US for the past several years. We were also selected as one of the 100 Best Places to Work in IT on IDG's Insider Pro and Computerworld's 2020 list. For many years running, we have been named by Forbes as one of America's Best Employers for Women and one of America's Best Employers for New Graduatesas well as one of America's Best Employers for Diversity. To learn more about our commitment to diversity and inclusion please visit: https://jobs.libertymutualgroup.com/diversity-inclusion

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.

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