Lost Time Claims Specialist - Workers' Compensation

Encova Insurance; South Carolina; Remote; USD 90,000 - 111,000; Full time

Job summary

A leading insurance provider seeks an experienced claims professional to manage workers’ compensation claims in South Carolina. Responsibilities include evaluating benefits, conducting investigations, and collaborating with stakeholders for timely resolutions. Candidates should have a minimum of three years' experience, strong communication skills, and proficiency in claims management systems. This position offers a salary up to $110,642 annually, with bonuses, remote work flexibility, and a comprehensive benefits package.

Benefits

Career advancement opportunities

Flexible schedules with early office closure on Fridays

Comprehensive benefits package including 401(k)

Wellness programs

Qualifications

• Minimum three years of experience in workers’ compensation insurance.
• Ability to manage claims through the litigation process.
• Must be eligible to obtain a workers' compensation adjuster license.
• Strong written and verbal communication skills.
• Proficiency in claims management systems.

Responsibilities

• Evaluate medical and indemnity benefits for claims.
• Conduct investigations on claims compensability.
• Collaborate with stakeholders for timely claim resolutions.
• Manage claims litigation and guide legal counsel.
• Prepare and present claims details in meetings.

Skills

Claims management expertise

Strong communication skills

Analytical skills

Proficiency in Microsoft Office

Education

Bachelor’s Degree

Tools

Claims management systems

Job description

What to Expect

• Evaluate and manage medical and indemnity benefits for work-related injury and disease claims
• Conduct thorough investigations and make determinations on claims compensability
• Collaborate with various stakeholders, including injured workers, employers, and medical professionals to facilitate timely claim resolutions
• Manage claims litigation and provide direction to legal counsel throughout the claims process
• Prepare and present claim details at internal team meetings and participate in claim reviews

What is Required (Qualifications)

• Minimum of three years of experience in workers’ compensation insurance
• Ability to manage claims through the litigation process
• Must be eligible to obtain a workers’ compensation adjuster license and pass the claims adjuster license exam(s) within 90 days of hire
• Strong written and verbal communication skills
• Proficiency in claims management systems and Microsoft Office suite

How to Stand Out (Preferred Qualifications)

• Bachelor’s Degree from an accredited college or university
• Experience in multiple state claims management
• Knowledge of workers’ compensation claims practices, laws, and court procedures
• Strong analytical skills and problem-solving abilities
• Ability to work effectively in a paperless environment

Why consider this job opportunity

• Salary range up to $110,642 annually, plus bonuses and benefits
• Opportunity for career advancement and growth within the organization
• Work remotely from approved states with flexible schedules, including early office closure every Friday
• Supportive and collaborative work environment with a focus on community engagement
• Comprehensive benefits package including 401(k) and wellness programs

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