Lost Time Claims Specialist, Workers' Compensation
Encova Insurance
CAT Claims Specialist
Frontline Insurance
full-time
Posted on:
Origin: • 🇺🇸 United States • Alabama, Florida, North Carolina, South Carolina, Virginia
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Investigate and verify loss details to determine coverage under the policy.
- Manage the full claims process, including fact-gathering, policy analysis, coverage recommendations, and issuing payments within authority.
- Coordinate property inspections and maintain consistent communication with insureds throughout the claim lifecycle.
- Determine appropriate investigative steps and engage external experts when necessary.
- Review claim documentation to establish facts and make timely decisions.
- Maintain thorough documentation of all claim activities and communications.
- Monitor and respond promptly to emails, calls, and inquiries.
- Establish and update reserves based on claim developments.
- Communicate clearly with all parties involved—insureds, adjusters, attorneys, and contractors—to provide updates and resolve inquiries.
- Submit timely reserve and payment approvals and escalate for management review as needed.
- Draft Reservation of Rights or denial letters, subject to managerial approval.
- Identify claims suitable for mediation or appraisal and initiate alternative dispute resolution processes.
- Attend mediations and leverage negotiation skills to resolve disputed claims.
- Oversee the appraisal process to ensure timely and effective resolution.
Requirements
- Bachelor’s degree in related field preferred
- Minimum of 3 years of experience in Property & Casualty Insurance or equivalent of combination of education and experience
- Maintain a Florida 620/720 License
- Ability to obtain Alabama, North Carolina, South Carolina, Virginia, and Georgia licenses within 90 days of hire
- Proficient in Microsoft programs
