Remote Lost Time Claims Specialist - Workers' Comp

Encova Mutual Insurance Group.; United States; Hybrid; USD 55,000 - 111,000; Full time

Benefits offered by this job

Health, Dental & Vision Insurance

401(k) Retirement Plan - company match

Paid Time Off & Holidays

Hybrid/Remote work options

Job summary

Encova Mutual Insurance Group seeks a Lost Time Claims Specialist in the United States to manage indemnity and medical benefits for workers’ compensation claims. The role involves investigation, evaluation, and determination of compensability, plus collaboration with medical, legal, and return-to-work teams to achieve cost-effective outcomes.

The ideal candidate has a bachelor’s degree and at least three years of workers’ compensation experience, with strong communication and analytical skills.

Qualifications

• Bachelor’s degree preferred.
• Three years of workers’ compensation experience required.
• Active workers’ compensation adjuster license preferred; must obtain license exams within 90 days of hire.
• Ability to manage claims through the litigation process.
• Strong written and verbal communication skills.

Responsibilities

• Evaluate and manage medical and indemnity benefits to cost-effective conclusions.
• Decide claim outcomes using established policy and guidelines.
• Gather facts via interviews with involved parties and record statements if needed.
• Determine eligibility of indemnity and medical benefits.
• Coordinate with medical, legal, and return-to-work teams to ensure feasible outcomes.
• Manage litigation expenses with panel counsel throughout the claim lifecycle.
• Analyze reports to adjust strategies and evaluate settlements.

Skills

Written communication

Verbal communication

Analytical skills

Time management

Multitasking

Teamwork

Problem solving

Initiative

Education

Bachelor’s Degree

Tools

Claims management system

Microsoft Office

Job description

Encova Mutual Insurance Group seeks a Lost Time Claims Specialist in the United States to manage indemnity and medical benefits for workers’ compensation claims. The role involves investigation, evaluation, and determination of compensability, plus collaboration with medical, legal, and return-to-work teams to achieve cost-effective outcomes.

The ideal candidate has a bachelor’s degree and at least three years of workers’ compensation experience, with strong communication and analytical skills.