Remote Lost Time Claims Specialist II - Florida/Georgia

UPMC; Pittsburgh (Allegheny County); On-site; USD 70,000 - 95,000; Full time

Job summary

UPMC Health Plan and WorkPartners is seeking a full-time Lost Time Claims Specialist II to join the Workers Comp Claims team. This remote role will support Florida and Georgia claims with EST business hours, Monday through Friday.

The ideal candidate will hold active Florida and Georgia Adjuster licenses and have prior experience managing lost time claims in both states. Responsibilities include coverage analysis, investigation, negotiation, and disposition of assigned claims under approved

Qualifications

• Bachelor’s and/or advanced degree or a minimum of 3 years of Workers’ Compensation claims handling experience.
• Minimum of 2 years of Workers’ Compensation lost time claims handling experience.
• Florida and Georgia Workers Comp Adjusters license strongly preferred.

Responsibilities

• Assign medical experts to cases and arrange examinations when needed.
• Develop lost time claim disposition skills under limited supervision.
• Pro-actively manages the case resolution process and may participate in mediations.
• Ensure proper referrals and timely updates to reinsurers and clients.
• Interact with claimants, attorneys, clients, and brokers to share status.
• Analyze information to determine the extent of loss for each claim.
• Manage litigation processes with counsel, within authority and guidelines.
• Proactively estimate reserves and advise on appropriate levels.

Skills

Lost time claims handling

Litigation management

Florida/Georgia Adjuster licenses

Claims analysis

Negotiation

Education

Bachelor's degree

Advanced degree

3 years Workers’ Compensation claims handling

Job description

UPMC Health Plan and WorkPartners is seeking a full-time Lost Time Claims Specialist II to join the Workers Comp Claims team. This remote role will support Florida and Georgia claims with EST business hours, Monday through Friday.

The ideal candidate will hold active Florida and Georgia Adjuster licenses and have prior experience managing lost time claims in both states. Responsibilities include coverage analysis, investigation, negotiation, and disposition of assigned claims under approved