Lost Time Claims Specialist – Workers' Compensation

This is a fully remote position, open to applicants in Connecticut, +21 more states.

📋 Description

• Oversee indemnity and medical workers’ compensation claims from initial investigation to a cost-effective resolution.

• Assess claims and create strategic action plans for medical and indemnity benefits.

• Evaluate compensability, eligibility for benefits, claim results, reserves, and settlement strategies.

• Collect information through interviews and recorded statements.

• Identify and pursue recoveries through subrogation.

• Collaborate with claim directors, return-to-work specialists, nurse case managers, medical professionals, and legal advisors.

• Work together with injured workers, employers, legal representatives, and healthcare professionals to control costs and enhance quality care.

• Ensure the safe and prompt return of injured workers to their jobs.

• Manage litigation of claims, associated expenses, and panel counsel.

• Analyze reports from physicians, attorneys, and vocational rehabilitation specialists.

• Evaluate and negotiate settlements for claims.

• Present claim information during internal team meetings and provide support.

• Engage in claim reviews, onboarding sessions, and meetings with policyholders and agents.

• Create presentations for special projects, meetings, and conferences.

• Partner with policyholders to align goals and drive ongoing improvements.

⛳️ Requirements

• Minimum of three years of experience in workers’ compensation insurance is required.

• Capability to manage claims throughout the litigation phase.

• Familiarity with workers’ compensation claims practices and laws, court procedures, precedents, and state regulations.

• Bachelor’s Degree from an accredited institution is preferred.

• One valid workers’ compensation adjuster license is highly preferred.

• Must be eligible to obtain additional licenses as necessary.

• Must successfully pass the claims adjuster license exam(s) within 90 days of employment.

• Candidates with experience in managing claims across multiple states may be given preference.

• Ability to apply logic and sound reasoning to discover alternative solutions to problems.

• Excellent written and verbal communication skills.

• Strong analytical capabilities.

• Proficiency in multitasking and effectively managing time for productivity.

• Ability to work efficiently both independently and as part of a team.

• Capacity to build and maintain strong relationships internally and externally.

• Experience in operating effectively in a paperless environment.

• Proficient in using laptops, claims management systems, and the Microsoft Office suite.

• Must reside and work within one of Encova’s eligible U.S. states.

🏝️ Benefits

• Bonus / company incentive bonus program.

• Health insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Company-sponsored life and income protection plans.

• 401(k) retirement plan with a 100% company match up to 7% of annual salary.

• Paid time off.

• Paid holidays.

• Floating holidays.

• Flexible work arrangements, which may include hybrid and remote options depending on the role.