Senior Claim Resolution Rep, NF

Are you looking for an opportunity to join a claims adjusting team with a responsible company that has consistently outpaced the industry in year over year growth? Liberty Mutual Insurance has an excellent claims opportunity available. In this role, you will be responsible for managing, investigating, and resolving first-party medical claims under general supervision. Additionally, you will assist in providing exemplary service to our policyholders. Training is a crucial element of your success, and it begins with consistent attendance. Active participation during training is mandatory.

Responsibilities

• Obtains information about accidents and injuries from customers and claimants through telephone and written reports.
• Reviews medical records, researches claimed medical treatment, and communicates with customers, claimants, physicians, medical providers, attorneys, and repair shops, etc.
• Secures the essential facts about accidents, assesses liability/compensability, negotiates settlements and explains denials to policyholders and claimants.
• Recognizes potential subrogation cases, prepares cases for subrogation and refers these cases to the Centralized Subrogation Unit.
• Reviews medical records and bills to verify claimed treatment is causally related to the accident and is reasonable and necessary given facts of the claim.
• Uses internet and Liberty Mutual contracted vendors for evaluation of medical payments and treatment.
• Consults with Nursing staff or Medical Doctors for validation of information as required.
• Follows ICP procedures to screen and rule out bodily injury claims and refers potential bodily injury.
• Obtains recorded interviews as required.
• Wage Claims, No-Fault and medical payment claims.
• Secures and reviews appropriate medical documentation to verify treatment and causal relationship.
• Registers claims, updates status notes, establishes target dates, communicates with others, schedules appraisals and releases payments on the automated system within limit of authority.
• Arranges Independent Medical Exams as required.
• Assists in the training, coaching and counseling of Claims Representatives.

Requirements

• During the training and onboarding period, you will be required to attend in person at the Orlando office 2-3 days a week.
• After onboarding, this will transition to a hybrid role, with a requirement to be in the Orlando office twice a month.
• Bachelor’s degree preferred; continuing insurance education desired.
• Thorough knowledge of insurance coverages, contracts & claims handling guidelines.
• Experience with general liability and auto liability encompassing injury and property losses.
• Experience with litigated claims.
• Ability to analyze variables, such as medical records and legal documentation.
• Ability to communicate effectively with people from all backgrounds and uphold our high standard of customer service.
• Negotiation and settlement skills.
• Hard work, honesty, integrity and unwavering business ethics.
• Detail-oriented organizational skills in a multi-tasking environment.
• Success driven individual who has demonstrated success in a claims adjusting role.

Employees may apply for a new role after completing 12 months of employment in their current position. Employees should review all role requirements and apply only for positions for which they are eligible. Hiring processes may vary by country, including differences in procedures, requirements, and timelines. For country-specific details, please consult your local recruiting / HR team.