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Forensic Underwriter, National Insurance
Liberty Mutual
Wausau, WI, United States
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Description
Advance Your Underwriting Career at Liberty Mutual Insurance- A Fortune 100 Company
Under minimal supervision, performs complex research and underwriting analysis to determine misrepresentation or fraud within the involuntary business market operations. Develops recommendations addressing problems, and refers to SIU (Special Investigative Unit) Manager and Managers. Manages assigned cases and provides assistance to SIU Forensic Consultants and/or attorneys in various stages of litigation.
Responsibilities:
• Thoroughly investigates complex issues related to ownership, classification, exposures, etc., through a comprehensive knowledge of all insurance rules and regulations. Makes effective use of management resources and understands multi-state coverage issues.
• Analyzes anomalies, inconsistencies, incomplete information, eligibility, coverage, exposure and ownership concerns that have been identified in the manual review.
• Works with plan administrator on complex ownership issues for combination of two or more companies for experience rating purposes.
• Evaluates information from internal service departments and external sources to gain a better understanding of the true operations and exposures of a risk as well as the proper premium computation.
• Completes manual rating of policies and experience modification factors utilizing thorough knowledge of system applications and the manual rules.
• Trains Involuntary Market Operations (IMO) staff on misrepresentation and fraud detection. Identifies potential premium leakage areas, develops and implements pro-active procedures with other department management teams.
• Analyzes financial impact / profitability of proceeding with further case review.
• Manages assigned cases and provides assistance to attorneys in various stages of litigation, mediation, appeals and /or disputes.
• Files Fraud Reports on assigned cases if required by state.
• Provide assistance to SIU Business Forensic Business Consultants on their assigned cases and attorneys in various stages of litigation, mediation, appeal and/or disputes.
• Serves as a fact witness in civil and/or criminal trial.
• Completes NP-10 Petition for Servicing Carrier Allowance on SIU accounts which qualifies and resolves questions by plan administrators.
• Bachelor's degree
• Minimum of 5 to 10 years related experience.
• Insurance Designation Certification (CPCU, NIS, etc..) preferred.
• Requires underwriting, analytical/problem solving and organizational skills.
• Must have a thorough knowledge of company practices and procedures in the areas of underwriting, auditing, billing, collections, claims; along with knowledge and experience with the workings, rules and interrelationships of the company and the various outside mechanisms that administer insurance programs throughout the country.
• Investigative mind set which can recognizes deviations in records and/or procedures.
• Acts as the Division contact for internal and external departments relating to misrepresentation or fraud issues.
Benefits:
We value your hard work, integrity and commitment to positive change. In return for your service, it’s our privilege to offer you benefits and rewards that support your life and well-being. To learn more about our benefit offerings please visit: https://LMI.co/Benefits
Overview:
At Liberty Mutual, we give motivated, accomplished professionals the opportunity to help us redefine what insurance means; to work for a global leader with a deep sense of humanity and a focus on improving and protecting everyday lives. We create an inspired, collaborative environment, where people can take ownership of their work; push breakthrough ideas; and feel confident that their contributions will be valued and their growth championed.
We’re dedicated to doing the right thing for our employees, because we know that their fulfillment and success leads us to great places. Life. Happiness. Innovation. Impact. Advancement. Whatever their pursuit, talented people find their path at Liberty Mutual.