Workers' Comp Lost Time Claims Specialist

Encova Insurance; Philadelphia (Philadelphia County); On-site; USD 55,132 - 110,642; Full time

Job summary

Encova Insurance is hiring a Lost Time Claims Specialist, Workers' Compensation, to manage indemnity and medical claims in a multi-jurisdictional environment. The role emphasizes policy-based decision making, cost-effective outcomes, and collaboration with medical professionals and legal teams.

Qualified candidates will have a bachelor's degree, at least three years in workers' compensation, and the ability to obtain required licenses.

Qualifications

• Bachelor’s degree preferred.
• Three years of experience in workers' compensation insurance.
• Active claims adjuster license preferred; must obtain if required.

Responsibilities

• Evaluate and establish an action plan to manage medical and indemnity benefits.
• Decide outcomes of claims using policy, procedures, and guidelines.
• Gather facts through interviews and record statements when needed.
• Determine eligibility of indemnity and medical benefits.
• Utilize proactive reserving to reflect probable outcomes.
• Identify and pursue subrogation recoveries when possible.
• Collaborate with directors, nurses, and medical/legal teams on treatment plans.
• Manage litigation with panel counsel throughout the life of the claim.
• Assist in preventing costs and ensuring return-to-work.
• Communicate effectively with workers, employers, and providers.

Skills

Communication

Analytical thinking

Multitasking

Laptops & MS Office

Education

Bachelor’s degree

Tools

Claims management systems

Microsoft Office

Job description

Encova Insurance is hiring a Lost Time Claims Specialist, Workers' Compensation, to manage indemnity and medical claims in a multi-jurisdictional environment. The role emphasizes policy-based decision making, cost-effective outcomes, and collaboration with medical professionals and legal teams.

Qualified candidates will have a bachelor's degree, at least three years in workers' compensation, and the ability to obtain required licenses.