Lost Time Claims Adjuster – Workers' Compensation
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Job Description
Managing lost time and medical only Workers' Compensation claims at Encova Insurance. Collaborating with various stakeholders and ensuring proper claim management.
Responsibilities:
- Manage lost time and medical only Workers' Compensation claims.
- Evaluates and establishes an action plan to manage medical and indemnity benefits associated with injury and occupational disease claims.
- Decides the outcome of the claim using sound judgment by applying established policy, procedures, regulations and guidelines.
- Gathers facts by conducting interviews with all involved parties and considers all the elements of the claim prior to issuing a decision.
- Determines eligibility of indemnity and medical benefits once salary information and medical treatment plans have been secured and processed.
- Utilize proactive reserving behaviors to ensure adequate case reserves.
- Consults with assigned claim director, return to work specialists, nurse case managers, and internal/external medical professionals.
- Works collaboratively with the injured worker, employer, outside counsel, and health and rehabilitation professionals to manage the claims costs.
Requirements:
- Bachelor’s Degree from an accredited college or university is preferred.
- Three years of experience in the field of workers’ compensation insurance required.
- Ability to manage claims through the litigation process.
- One valid workers’ compensation adjuster license is strongly preferred.
- Preference may be shown to candidates with multiple state claims management experience.
- Experience in workers’ compensation claims practices and laws, court procedures, precedents and state statutes.
- Ability to use logic and sound reasoning to identify alternative solutions for problem-solving.
- Strong written and verbal communication skills.
- Strong analytical skills.
- Ability to multitask and manage time effectively and productively.
Benefits:
- Health, Dental & Vision Insurance
- Company-provided life and income protection plans
- Eligibility to participate in a company incentive bonus program
- 401(k) Retirement Plan - 100% company match up to 7% on annual salary
- Paid Time Off, Paid Holidays, and Floating Holidays
- Flexible Work Arrangements - Hybrid and remote depending on the role
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