Lost Time Claims Specialist, Workers' Compensation
Encova Insurance
Salary
💰 $60,000 - $70,000 per year
Job Level
JuniorMid-Level
About the role
- Adjust Commercial Property contents and tenant caused damage claims files for the life of the claim.
- Determine covered insurance losses by studying provisions of a policy or certificate.
- Establish proof of loss by studying documentation and assembling additional information from outside sources.
- Document specific claims by completing and recording forms, reports, logs, and records.
- Analyze insurance claims and interview claimants to prevent fraud.
- Prepare reports by collecting, analyzing, and summarizing information in accordance with service level agreements and requirements with Lloyd's
- Resolve claims by approving or denying documentation, calculating benefits due, and determining compensation settlement as permitted by Coverholder Agreement.
- Ensure legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.
- Maintain quality customer service by following customer services practices and responding to customer inquiries in a timely and consistent fashion.
- Communicate with all claim stakeholders, including claimants, brokers, internal underwriting and client success team, carriers/syndicates, etc.
- Assist with the completion of ad hoc projects as needed.
- Resolve claims fairly and timely abiding by all regulatory (DOI) mandates.
- Maintain all necessary claim licensing.
- Ensure legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.
- Other duties as assigned by the team and leadership.
Requirements
- 2-5 years of property and casualty insurance claims and coverage experience.
- Experience with Lloyd's policies is a plus.
- Subrogation experience is a plus.
- Active adjusters license in home state (Texas or Florida or willingness to re-activate a prior license immediately upon hiring) as well as all states that require a license for claims adjusting.
- Direct communication with clients; strong written, oral and presentation communication skills, with a commitment to impeccable client service are required; ability to adjust easily to working well with a variety of workstyles.
- Great, positive attitude and the ability to work independently under pressure.
- Ability to complete quality work and solve insured/claimant Issues minimal supervision.
- Ability to manage and analyze high volumes of complex information.
- Advanced analytical and problem-solving skills.
- Outstanding organizational skills and attention to detail.
- Willingness to grow and develop.
- Must have familiarity and good working knowledge of various Microsoft software applications (Excel), Agency Management Systems, and the ability to learn new software systems.
- Ability to be flexible, adaptable, and work in a team environment that is constantly evolving.
- Ability to negotiate and utilize conflict management skills.
