Lost Time Claims Specialist – Workers' Compensation

This is a fully remote position, open to applicants in Iowa.

📋 Description

• Assess and develop action strategies to administer medical and indemnity benefits for claims related to injuries and occupational diseases.

• Determine claim resolutions by utilizing established policies, procedures, regulations, and guidelines.

• Investigate claims through fact-finding and interviews with all parties involved.

• Record statements when deemed necessary.

• Assess eligibility for both indemnity and medical benefits.

• Maintain sufficient case reserves that accurately reflect likely claim outcomes.

• Identify and seek out subrogation recoveries.

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

• Work together with injured workers, employers, legal counsel, and health and rehabilitation professionals to manage claim expenses and ensure quality care.

• Support injured workers' safe and prompt return to their jobs.

• Oversee claims litigation and direct panel counsel.

• Analyze external reports and adjust claim strategies accordingly.

• Assess and negotiate claim settlements.

• Present claim information during internal team meetings and offer guidance.

• Consult with claim directors on complicated or financially significant losses.

• Adhere to best practices in claims management concerning medical oversight, litigation, fraud/abuse detection, and recovery efforts.

• Prioritize tasks and complete work to satisfy jurisdictional requirements, timelines, and internal metrics.

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

• Engage in claim reviews, onboarding processes, and related activities for policyholders and agents.

• Work proactively with policyholders to align goals and encourage ongoing improvement.

⛳️ Requirements

• A Bachelor's Degree from an accredited college or university is preferred.

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

• Capability to manage claims throughout the litigation process.

• Internal candidates must show familiarity with Encova Best Practices guidelines and meet quality benchmarks.

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

• Must be eligible to obtain any additional licenses as necessary.

• Required to pass assigned claims adjuster licensing examinations within 90 days of hire.

• Preference may be given to candidates with experience in managing claims across multiple states.

• Understanding of workers’ compensation claims practices, laws, court procedures, precedents, and state statutes.

• Ability to apply logic and sound reasoning to solve problems.

• Exceptional written and verbal communication abilities.

• Strong analytical skills.

• Proficient in multitasking and effectively managing time.

• Capable of working both independently and collaboratively in a team setting.

• Skilled in developing and maintaining effective relationships internally and externally.

• Proficient in operating effectively within a paperless environment.

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

🏝️ Benefits

• Bonus opportunities.

• Health, Dental & Vision Insurance.

• Company-sponsored life and income protection plans.

• Eligibility to participate in a company incentive bonus program.

• 401(k) Retirement Plan with 100% company match up to 7% of annual salary.

• Paid Time Off, Paid Holidays, and Floating Holidays.

• Flexible Work Arrangements, including hybrid and remote options depending on the role.

• Engaging, challenging, and financially rewarding career opportunities.

• Opportunities for professional and personal growth.

• Access to learning and development resources.