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Claims Specialist
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Claims Assistant
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Denial Resolution Specialist
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authorization specialist
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Workers Compensation Specialist
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Medical Claims Analyst
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Medical Claims Analyst
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QA/Expeditor - Ft Apache Chili's
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Complex Technical Claims Specialist II - Las Vegas, United States - Liberty Mutual Insurance
Description
Pay PhilosophyThe experience expected from applicants, as well as additional skills and qualifications needed for this job are listed below.
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.
DescriptionUnder limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of 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.
ResponsibilitiesInvestigates claims to determine whether coverage is provided, 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 non-Complex staff.Qualifications
A Bachelors degree or equivalent business experience is required
In addition, the candidate will generally posses 5-7 years of related claims experience with 1-2 years of experience in complex claims
Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skill required
About Us
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 Graduates as well as one of America's Best Employers for Diversity.
To learn more about our commitment to diversity and inclusion please visit:
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.
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.
