Description

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.

Be part of a team that makes a real difference.

Full-Time Remote Position | New Jersey Focus

Investigates, evaluates, disposes of and settles the most complex and highest exposure claims with minimal supervision, including the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reserves in accordance with legal statutes, policy provisions and company guidelines.

Key Responsibilities: 

• Understand concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims toward resolution using Best Practices.
• Promptly investigate all assigned claims for coverage, liability assessment and damages.
• Expected to manage a claim pending of approximately 175 files, the majority of which are in litigation.
• Investigate claims by interviewing claimants and witnesses, establish claim reserves, handle evidence, obtain evidence, obtain and interpret official reports, medical reports and claim forms, and attend/participate at mediation, trials or hearings.
• Negotiate and settle claims, set reserves and manage litigation within client service parameters and authority levels by obtaining demands and making offers to claimants.
• May present evidence at legal proceedings.
• Pursue subrogation when appropriate.
• Document plan of action in the claim system and set appropriate diaries.
• Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
• Close all files as appropriate in a timely and complete manner.
• Maintain closing ratio as directed by management team.
• Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors.
• Perform other duties as required.

Education & Qualifications:

• High school diploma or equivalent required
• Associates or Bachelor's degree preferred (can be substituted with additional relevant experience)
• 4+ years of New Jersey workers' compensation claims experience

Your Experience & Knowledge:

• 4+ years handling New Jersey workers' compensation claims
• Understanding of NJ workers' compensation statutes and procedures
• Background in insurance, healthcare, or legal industries
• Familiarity with medical terminology and injury treatments
• Ability to analyze and interpret complex medical reports

Your Professional Strengths:

• Strategic prioritization skills that keep complex caseloads moving forward
• Time management expertise that balances thoroughness with efficiency
• Clear and persuasive communication that builds trust with all stakeholders
• Negotiation abilities that create win-win solutions
• Analytical thinking that identifies optimal claim resolutions

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