Complex Claims Specialist, Long-Term Care Professional Liability

Liberty Mutual has an immediate opening for a Complex Claims Specialist to join our Long-Term Care (LTC) Claims Team and assist with other specialty lines claims including Miscellaneous Medical Facilities, Custom, and Group Practice. This is a high‑visibility, hands‑on role for an experienced professional‑liability claims handler. With minimal supervision, the Complex Claims Specialist will manage a book of specialty LTC Professional Liability Claims, MMF, Custom, and/or Group Practice through the entire lifecycle, applying advanced coverage interpretation, clinical issue spotting, complex litigation management and prudent reserving to resolve high‑exposure matters economically and defensibly.

Why this role matters

• Lead ownership of complex professional liability claims (nursing homes, assisted living, hospice, home health, ancillary providers, physician groups, and other facilities).
• Opportunity to shape claim strategy on high‑severity matters, coordinate clinical/expert resources, and act as an internal subject‑matter resource for underwriting, reinsurance and senior leadership.
• Work in a collaborative environment with autonomy to influence outcomes and policy.

Key Responsibilities

• Own and manage Long Term Care as well as Misc. Medical Facilities, Custom, and Group Practice claims from first notice through resolution: investigate, analyze coverage, evaluate liability and damages, establish and adjust reserves, negotiate settlements and close files within authority.
• Perform advanced coverage analysis (duty to defend vs. indemnify, occurrence vs. claims‑made, allocation, additional insured issues, contractual liability, tail exposures, endorsements) and prepare clear coverage opinions and reservation of rights/declination communications.
• Document claims thoroughly using Claims Management System and proactively diary follow‑up actions and deadlines.
• Set indemnity and expense reserves within authority; escalate and recommend reserves for matters outside authority; review reserves regularly and justify reserve positions to management and auditors.
• Manage litigation: retain and oversee outside defense counsel with applicable expertise, control budgets and billing, direct discovery strategy, and evaluate mediation/arbitration/trial risk to optimize resolution.
• Coordinate clinical resources and expert consultants (nursing, pharmacy, infection control, medical specialists) for chart review, causation analysis and expert testimony.
• Interface with regulatory, compliance and risk management teams on CMS/state surveys, licensing investigations and mandatory reporting; incorporate regulatory developments into case strategy.
• Collaborate with underwriting, reinsurance and subrogation on allocation, ceded reporting and recovery opportunities.
• Identify and report claim trends, coverage exposures and policy issues to management and underwriting; contribute to playbooks, training and process improvements.
• Participate in mediations and arbitrations within settlement authority and support major loss response efforts.
• Maintain required adjuster licenses and adhere to company litigation and billing guidelines.

There is a strong preference for the selected candidate to live within 50-mile radius of one of the listed hub offices: Boston, MA; Plano, TX; Suwanee, GA; Indianapolis, IN; Hoffman Estates, IL; Lake Oswego, OR; Las Vegas, NV, Chandler, AZ or Weatogue, CT. This policy is subject to change. We will consider a remote candidate if you do not live within 50-miles of one of these offices.