Hybrid/Remote Lost Time WC Claims Specialist

3M HEALTHCARE; Illinois; Hybrid; USD 59,630 - 119,670; Full time

Benefits offered by this job

Health, dental and vision insurance

Life and income protection plans

Bonus program

401(k) with 100% match up to 7%

Paid time off and holidays

Hybrid or remote work flexibility

Job summary

Encova Insurance is seeking a Lost Time Claims Specialist, Workers’ Compensation to manage indemnity and medical claims, investigate and determine compensability, and support related claims specialists. The role requires strong analytical skills and collaboration across the enterprise.

Responsibilities include evaluating plans, coordinating with medical providers and counsel, negotiating settlements, and ensuring timely, cost-effective claim resolution while adhering to policy and regulatory

Qualifications

• Bachelor’s Degree preferred.
• Three years of experience in workers’ compensation insurance.
• Ability to manage claims through the litigation process.
• One valid workers’ compensation adjuster license is strongly preferred; eligibility to obtain additional licenses required.
• Must pass the claims adjuster license exam(s) within 90 days of hire.
• Preference for experience managing claims in multiple states.
• Experience with workers’ compensation practices, laws, and procedures.

Responsibilities

• Evaluate and establish an action plan to manage medical and indemnity benefits for injury and occupational disease claims to a cost-effective conclusion.
• Decide claim outcomes using established policy, procedures, regulations and guidelines.
• Gather facts by interviewing involved parties and consider all elements of the claim before issuing a decision.
• Collaborate with claim director, return-to-work specialists, nurse case managers, medical and legal professionals to ensure outcomes are achievable.
• Analyze reports to evaluate and adjust claim strategies as needed.
• Negotiate claim settlements to achieve the best possible outcome.
• Present and summarize claim details at internal staffing meetings as needed.

Skills

Strong communication skills

Analytical skills

Time management

Team collaboration

Independent work

Education

Bachelor’s Degree

Tools

Microsoft Office

Job description

Encova Insurance is seeking a Lost Time Claims Specialist, Workers’ Compensation to manage indemnity and medical claims, investigate and determine compensability, and support related claims specialists. The role requires strong analytical skills and collaboration across the enterprise.

Responsibilities include evaluating plans, coordinating with medical providers and counsel, negotiating settlements, and ensuring timely, cost-effective claim resolution while adhering to policy and regulatory