Commercial No Fault PIP/ Med Pay Adjuster - Claims Specialist II

At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.

The Claims Specialist analyzes complex Personal Injury Protection (PIP) and Medical Payment (Med-Pay) No Fault claims, determines benefits owed, manages and adjudicates high‑exposure claims to meet service standards and client requirements. The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about coverage and eligibility, evaluating losses, medically managing claims, paying medical bills, and negotiating settlements. The role interacts with claimants, policyholders, providers, attorneys, and other third parties throughout the claim’s management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.

• →Manages an inventory of claims.
• →Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
• →Plans and conduct investigations of claims to confirm coverage and eligibility to medically manage the claims through resolution.
• →Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
• →Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
• →Performs other duties as assigned.

• BS/BA degree or equivalent work experience.
• Minimum of 2 years’ experience in claims adjustment, general insurance or formal claims training.
• Required to obtain and maintain all applicable licenses.
• Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU).
• Knowledge of claims investigation techniques, medical terminology and legal aspects of claims.