Lost Time Claims Specialist, Workers Compensation

🔥 21 hours ago

🦌 Connecticut, Florida, +20 more states – Remote

🦌 Connecticut – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🐎 Kentucky – Remote 🌾 Nebraska – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote

💵 $55.1k - $110.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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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

• Manage indemnity claims, including investigation, evaluation, and compensability determinations for work-related injury and disease claims • Establish action plans to manage medical and indemnity benefits to cost-effective conclusions • Apply policies, procedures, regulations, and guidelines to determine claim outcomes and benefit eligibility • Conduct interviews and take recorded statements when necessary • Set and maintain adequate case reserves • 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 safe and timely return to work • Manage claims litigation and direct panel counsel • Analyze reports from physicians, attorneys, and vocational rehabilitation experts • Evaluate and negotiate claim settlements • Present claim details at internal team staffing and provide guidance • Participate in claim reviews, onboardings, meetings, and special projects • Collaborate with policyholders to align objectives and foster continuous improvement

🎯 Requirements

• Three years of experience in the field of workers’ compensation insurance required • Ability to manage claims through the litigation process • Must be eligible to obtain additional workers’ compensation adjuster licenses as required • Must pass the claims adjuster license exam(s) as assigned within 90 days of being hired • Experience in workers’ compensation claims practices and laws, court procedures, precedents and state statutes • Ability to use logic and sound reasoning to identify alternative solutions for problem-solving • Strong written and verbal communication skills • Strong analytical skills • Ability to multitask and manage time effectively and productively • Work effectively independently as well as in a team environment • Develop and maintain strong, effective internal and external relationships • Work effectively in a paperless environment • Skilled in the use of laptops, claims management systems, and Microsoft Office suite • Bachelor’s Degree from an accredited college or university is preferred • One valid workers’ compensation adjuster license is strongly preferred • Must reside and work within one of Encova’s eligible U.S. states

🏖️ Benefits

• Bonus/incentive bonus program • Health, Dental & Vision Insurance • Company-provided life and income protection plans • 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 • Learning and growth opportunities