Lost Time Claims Specialist – Workers' Compensation

🔥 0 minutes ago

🌾 Iowa – Remote

🌾 Iowa – Remote

💵 $55.1k - $110.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Encova Insurance

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🛡️ Insurance

💸 Finance

👥 B2C

Insurance • Finance • B2C

Encova Insurance is an insurance company dedicated to providing comprehensive insurance solutions for both personal and commercial needs. With decades of experience in the industry, Encova Insurance offers a wide range of products including home, auto, and workers' compensation insurance, while specializing in tailored commercial packages for complex businesses. They prioritize innovation and customer service, ensuring policyholders receive the support and coverage necessary for long-term success.

📋 Description

• Evaluate and establish action plans to manage medical and indemnity benefits for injury and occupational disease claims • Decide claim outcomes by applying established policies, procedures, regulations, and guidelines • Investigate claims by gathering facts and conducting interviews with involved parties • Take recorded statements when necessary • Determine eligibility for indemnity and medical benefits • Maintain adequate case reserves reflecting probable claim outcomes • Identify and pursue subrogation recoveries • Consult with claim directors, return-to-work specialists, nurse case managers, medical professionals, and legal counsel • Collaborate with injured workers, employers, counsel, and health and rehabilitation professionals to manage claim costs and promote quality care • Facilitate injured workers' safe and timely return to work • Manage claims litigation and direct panel counsel • Analyze external reports and adjust claim strategies • Evaluate and negotiate claim settlements • Present claim details at internal team staffing and provide guidance • Consult with claim directors on complex or financially escalating losses • Follow claims best practices related to medical management, litigation, fraud/abuse, and recovery • Prioritize and complete work to meet jurisdictional requirements, timeframes, and internal metrics • Develop presentations for special projects, meetings, and conferences • Participate in claim reviews, onboardings, and related activities for policyholders and agents • Collaborate proactively with policyholders to align objectives and foster continuous improvement

🎯 Requirements

• Bachelor's Degree from an accredited college or university is preferred • Three years of experience in workers’ compensation insurance required • Ability to manage claims through the litigation process • Internal candidates must demonstrate knowledge of Encova Best Practices guidelines and meet quality standards • One valid workers’ compensation adjuster license is strongly preferred • Must be eligible to obtain additional licenses as required • Must pass assigned claims adjuster license exam(s) within 90 days of being hired • Preference may be shown to candidates with multiple-state claims management experience • Knowledge of workers’ compensation claims practices and laws, court procedures, precedents, and state statutes • Ability to use logic and sound reasoning for problem-solving • Strong written and verbal communication skills • Strong analytical skills • Ability to multitask and manage time effectively and productively • Ability to work effectively independently and in a team environment • Ability to develop and maintain effective internal and external relationships • Ability to work effectively in a paperless environment • Skilled in using laptops, claims management systems, and Microsoft Office suite

🏖️ Benefits

• Bonus • Health, Dental & Vision Insurance • Company-provided life and income protection plans • Eligibility to participate in a company incentive bonus program • 401(k) Retirement Plan - 100% company match up to 7% on annual salary • Paid Time Off, Paid Holidays, and Floating Holidays • Flexible Work Arrangements - Hybrid and remote depending on the role • Challenging, stimulating, and financially rewarding opportunities • Professional and personal growth • Learning and development opportunities