We’re committed to putting people first – if you need an accommodation as you go through the job searching, application, and interviewing process, please click here for more information.
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Licensing may be required in some jurisdictions Effective written skills to compose clear, succinct descriptions when posting files and drafting correspondence. 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Expert-level machine learning & statistical modeling practitioner with track record for delivering measurable business value. Deep knowledge of insurance claims processes, especially in Workers' Compensation or other medical-driven lines of business (e.g., Medical & Casualty, Disability). Experienced in Python development with object-oriented design and engineering best practices. Demonstrated AI/ML Ops experience including model lifecycle management, experimentation, evaluation, monitoring, and operational readiness in a cloud-native enterprise environment. Demonstrated ability to measure AI/ML and GenAI system quality and business impact using quantitative and qualitative approaches. Experience partnering with technical and business stakeholders in complex, enterprise environments. Experience delivering ML and AI products through Python API and Application frameworks like FastAPI and Streamlit (or equivalent) Demonstrated experience delivering business value with Generative & Agentic AI in an enterprise setting Building, deploying, and maintaining AI products using leading frontier models from providers like OpenAI, Anthropic, and Google Experience building generative & agentic AI solutions using frameworks like LlamaIndex, LangChain, LangGraph, or equivalent Exposure to CrewAI, AgentCore, or other agentic orchestration frameworks Familiarity with vector databases and embedding-based retrieval systems Deep knowledge of predictive analytic techniques and statistical diagnostics of models. Expert knowledge of predictive toolset. Demonstrated ability to exchange ideas and convey complex information clearly and concisely. Ability to establish and build relationships within and outside the organization. Ability to give effective training and presentations to management, executives and other groups. Ability to use results of analysis to persuade team, department management or senior management to a particular course of action. Deep knowledge of business drivers and market context. Has a value driven perspective with regard to understanding of work context and impact. 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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 LTC 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. Bachelors' and/or advanced degree. J.D. is a plus! 7 + years claims/legal experience, with at least 2 years within a technical specialty preferred. Healthcare Claims experience strongly desired (Long-Term Care Professional Liability, Miscellaneous Medical Facilities and/or Group Practice claims). Advanced knowledge of claims handling concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge. Functional knowledge of law and insurance regulations in various jurisdictions. Demonstrated advanced verbal and written communications skills. Demonstrated advanced analytical, decision making and negotiation skills. Obtain and maintain Adjuster's license.", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": "remote_local", "canonicalPositionUrl": "https://searchjobs.libertymutualgroup.com/careers/job/618520616463", "isPrivate": false, "latlongs": "41.8437093,-72.8284317"}, {"id": 618520566690, "name": "Senior Technical Claims Specialist - Commercial Casualty Complex", "posting_name": "Senior Technical Claims Specialist - Commercial Casualty Complex", "location": "Remote, Remote, United States", "locations": ["Remote, Remote, United States"], "hot": 0, "department": "Claims", "business_unit": "3026-GRS-North America-US", "t_update": 1793728020, "t_create": 1793373600, "ats_job_id": "262437", "display_job_id": "2026-262437", "type": "ATS", "id_locale": "2026-262437-en", "job_description": "As the claim's owner, determines coverage, investigates the claims, determines liability, sets and adjusts reserves, evaluates the claim, negotiates a settlement, authorizes and pays the claim; may deny claims. Reviews lawsuit documentation and supporting documents, claims file, investigation, etc. Establish actions to be taken to resolve lawsuit. Includes determining loss coverage, amounts owed, discovery plans, setting reserves and negotiations. Establishes appropriate working team (Home Office Legal, Defense Counsel and Home Office Claims) based on allegations established in suit. Responsible for managing the practices and billing activities of outside counsel. Accountable for security of financial processing of claims, as well as security information contained in claims files. Trains and mentors staff as appropriate; manages relationships and acts as liaison with various business partners (e.g., Underwriting, Reinsurance, Etc.). Keeps abreast of existing and proposed legislation, court decisions and trends and experience pertaining to specialty coverage issues. May analyze the impact upon claims policies and procedures and advises Claims. Management so appropriate action can be taken where required. Participates in special projects. Bachelor's degree and 5 to 7 years claims adjusting experience. Advanced knowledge of commercial casualty claims investigation, coverage evaluation, reserving & expense management, resolution strategy, negotiation, litigation management, claims evaluation as well as the insurance legal and regulatory environment. Intermediate to advanced level of skill in the area of customer focus, problem solving, communications, gaining support, teamwork, and adaptability and demonstrated ability to work independently, achieve results and execute thoroughly. Bodily Injury litigated claims experience required. Commercial Casualty Claims experience preferred, along with multi-jurisdiction and dedicated accounts.", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": "remote_local", "canonicalPositionUrl": "https://searchjobs.libertymutualgroup.com/careers/job/618520566690", "isPrivate": false, "latlongs": "37.09024,-95.712891"}, {"id": 618520563968, "name": "Senior Claims Specialist, Miscellaneous Medical Facilities & Long-Term Care Professional Liability", "posting_name": "Senior Claims Specialist, Miscellaneous Medical Facilities & Long-Term Care Professional Liability", "location": "Weatogue, Connecticut, United States", "locations": ["Weatogue, Connecticut, United States", "Remote, Remote, United States", "Boston, Massachusetts, United States", "Chicago, Illinois, United States", "Plano, Texas, United States"], "hot": 0, "department": "Claims", "business_unit": "3026-GRS-North America-US", "t_update": 1793682180, "t_create": 1793361840, "ats_job_id": "262428", "display_job_id": "2026-262428", "type": "ATS", "id_locale": "2026-262428-en", "job_description": "Analyzes, investigates, and evaluates MMF/LTC Professional Liability claims from first notice of loss through resolution he loss to determine coverage and claim disposition. Within prescribed settlement authority for the line of business, establishes appropriate reserves for both indemnity and expense and reviews on a regular basis to ensure adequacy. Makes recommendations to set reserves at appropriate level for claims outside of authority level. Prepares comprehensive reports as required. Identifies and communicates specific claim trends and account and/or policy issues to management and underwriting. Manages the litigation process through the retention of counsel. Adheres to the line of business litigation guidelines to include budget, bill review and payment. Monitors the case resolution process. Actively participates in mediations and arbitrations, within limit of settlement authority. Participates in meetings with brokers, risk managers, and reinsurers. As required, maintains insurance adjuster licenses. Bachelors' and/or advanced degree. JD is a plus, especially with experience litigating Professional Liability claims (MMF or LTC). 5+ years claims/legal experience, with substantive, hands-on, medical Professional Liability claims (providers and/or facilities). Functional knowledge of claims handling Professional Liability concepts, practices and techniques, to include but not limited to coverage issues, and product line knowledge. Functional knowledge of law and insurance regulations in various jurisdictions common to Miscellaneous Medical Facilities and/or Long-Term Care Professional Liability. Proven analytical, negotiation and written/verbal communication skills; able to present complex clinical and coverage positions to Counsel, Underwriters, Senior Management, and other applicable parties.", "stars": 0.0, "medallionProgram": null, "location_flexibility": null, "work_location_option": "remote_local", "canonicalPositionUrl": "https://searchjobs.libertymutualgroup.com/careers/job/618520563968", "isPrivate": false, "latlongs": "41.8437093,-72.8284317"}, {"id": 618520557665, "name": "Senior Claims Representative", "posting_name": "Senior Claims Representative", "location": "Remote, Remote, United States", "locations": ["Remote, Remote, United States", "Boston, Massachusetts, United States", "Suwanee, Georgia, United States", "Plano, Texas, United States", "Hoffman Estates, Illinois, United States"], "hot": 0, "department": "Claims", "business_unit": "3026-GRS-North America-US", "t_update": 1793906760, "t_create": 1793323080, "ats_job_id": "262426", "display_job_id": "2026-262426", "type": "ATS", "id_locale": "2026-262426-en", "job_description": "Investigates claim using internal and external resources including speaking with the insured or other involved parties, analysis of reports, researching past claim activity, utilizing evaluation tools to make damage and loss assessments. Extensive and timely direct interaction with Insured's, Claimants, Agent's and Internal Customers. Determines policy coverage through analysis of investigation data and policy terms. Notifies agent and insured of coverage or any issues. Establishes claim reserve requirements and makes adjustments, as necessary, during the processing of the claims. Determines and negotiates settlement amount for damages claimed within assigned authority limits. Writes simple to moderately complex property damage estimates or review auto damage estimates. Takes statements when necessary and works with the Field Appraisal, Subrogation, Special Investigative Unit (SIU) as appropriate. Maintains accurate and current claim file/damage documentation and diaries throughout the life cycle of claim cases to ensure proper tracking and handling consistent with established guidelines and expectations. Alerts Unit Leader to the possibility of fraud or subrogation potential for claims being processed. Bachelor's Degree preferred. High school diploma or equivalent required. 1-2 years of experience. Claims handling skills preferred. Strong customer service and technology skills. Able to navigate multiple systems, strong organizational and communication skills. 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Strong litigation management experience, including selection and supervision of outside defense counsel, bill oversight and cost control. Practical understanding of clinical issues common to LTC (falls, pressure injuries, medication errors, infections/outbreaks, staffing/care plan issues) and relevant regulatory landscape. Proven analytical, negotiation and written/verbal communication skills; able to present complex clinical and coverage positions to counsel, underwriters and senior management. 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!important;-webkit-transition: background-color 300ms linear;-ms-transition: background-color 300ms linear;transition: background-color 300ms linear;} .fa-brands{-webkit-font-smoothing: antialiased; font-style: normal; font-variant: normal; line-height: 1; text-rendering: auto;font-family: 'Font Awesome 6 Brands'} .position-details li{list-style-type: disc;} .header-wrapper{display:none!important;}.disability p {text-align:center!important;background-color:#F0F0F0!important; height:45px!important;padding-top:12px!important;} .disability a {color:blue!important;text-decoration:underline!important;} @media only screen and (max-width: 1325px){.disability p {height:67px!important;}} @media only screen and (max-width: 675px){.disability p {height:92px!important;}} @media only screen and (max-width: 480px){.disability p {height:114px!important;}}h4{margin-top: 5px;font-weight: 600;}