Lost Time Claims Specialist Workers Compensation
@ Encova Insurance

Hybrid
$80,000
Hybrid
Full Time
Posted 23 days ago

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XXXXXXXX XXXXXXXXXXX XXXXXXX***** @encovainsurance.com
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Job Details

Job Objective

The Lost Time Claims Specialist Workers Compensation primarily manages indemnity claims. The role involves investigating, evaluating, and determining the compensability of work-related injury and disease claims. The objective is to provide superior service in a cost-effective manner while proactively collaborating across the enterprise for continuous improvement.

Essential Functions

Evaluate medical and indemnity benefits claims using established guidelines. Decide claim outcomes, conduct interviews, record statements, and secure necessary information for benefit eligibility. Utilize proactive reserving, manage subrogation recoveries, collaborate with internal teams including claim directors, medical, legal, and rehabilitation professionals, and manage claims litigation and settlements. Present claim details at internal meetings and participate in reviews and onboardings.

  • Investigate and evaluate claim details.
  • Determine eligibility and manage reserving.
  • Collaborate with medical, legal, and rehab teams.
  • Negotiate settlements and manage litigation.
  • Develop presentations for special projects.

Other Functions

Perform other duties as assigned.

Knowledge, Skills and Abilities

Bachelor’s Degree preferred and 3 years relevant experience required. Must have knowledge in workers’ compensation claims practices, laws, court procedures, and state statutes. Ability to use sound judgment, strong analytical, written and verbal communication skills, and multi-task in a paperless environment using systems like Microsoft Office and claims management software. Valid workers’ compensation adjuster license is strongly preferred, and candidates must be eligible to obtain additional licenses.

What You Can Expect From Us

Encova Insurance offers a competitive salary, bonus, and benefits package including a 401(k), wellness programs, flexible schedules with an early Friday close, and participation in community initiatives. The company is an equal opportunity employer and supports a diverse work environment.

How to Get Hired at Encova Insurance

🎯 Tips for Getting Hired

  • Research Encova Insurance's culture: Understand company values and policies.
  • Customize your resume: Highlight relevant claims management experience.
  • Prepare for technical questions: Review workers compensation laws.
  • Practice behavioral responses: Showcase analytical and negotiation skills.
  • Network with current employees: Leverage referrals if possible.

📝 Interview Preparation Advice

Technical Preparation

Review workers compensation regulations.
Study claims reserving methods.
Practice using claims management software.
Brush up on legal and medical report analysis.

Behavioral Questions

Describe team collaboration experiences.
Explain challenging claim negotiations.
Discuss handling high-pressure situations.
Share problem-solving examples in past roles.

Frequently Asked Questions