• Job Description

  Req#: 18095
  Company Overview
  
  
  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.
  
  Job Description
  
  
  Full-time, remote position
  *Must be located in the New Jersey area for onsite meetings*
  Independently investigates, evaluates, and resolves assigned New Jersey Workers’ Compensation lost time claims of a more complex or litigated nature in a timely manner in accordance with legal statutes, policy provisions and company guidelines.
  • Evaluate claimant eligibility; communicate with attending physician, employer and injured worker.
  • Manage high exposure, complex and catastrophic claims.
  • Work with both the claimant and their physician to medically manage the claim, from initial medical treatment to reviewing and evaluating ongoing treatment and related information.
  • Work directly with employers to facilitate a return to work, either on a full-time or modified duty basis.
  • Identify potential for third party recovery, including subrogation, Second Injury Fund or other fund involvement (when applicable) and excess or reinsurance reimbursement.
  • Establish compensability status through case investigation and evaluation and application of jurisdictional statutes and laws.
  • Where litigation is filed, evaluate exposure and work with defense counsel to establish strong defenses, prepare litigation plan of action, set legal reserve and manage litigation over life of claim.
  • Manage diary in accordance with Best Practices and complete tasks to ensure that cases move to the best financial outcome and timely resolution.
  
  Qualifications
  
  
  Education:
  High School diploma required; Associate’s or Bachelor’s degree preferred
  Experience:
  At least 2-3 years of experience handling New Jersey workers’ compensation claims required; more experience may be required depending upon complexity of claim pending.
  
  Benefits
  
  
  We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $48,824 - $52,985.60 annually, and will be based on a number of additional factors including skills, experience, and education.
  The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.
  Don’t meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.
  #LI-AP1
  #ENT
  
  
  Education:
  High School diploma required; Associate’s or Bachelor’s degree preferred
  Experience:
  At least 2-3 years of experience handling New Jersey workers’ compensation claims required; more experience may be required depending upon complexity of claim pending.
  
  
  Full-time, remote position
  *Must be located in the New Jersey area for onsite meetings*
  Independently investigates, evaluates, and resolves assigned New Jersey Workers’ Compensation lost time claims of a more complex or litigated nature in a timely manner in accordance with legal statutes, policy provisions and company guidelines.
  • Evaluate claimant eligibility; communicate with attending physician, employer and injured worker.
  • Manage high exposure, complex and catastrophic claims.
  • Work with both the claimant and their physician to medically manage the claim, from initial medical treatment to reviewing and evaluating ongoing treatment and related information.
  • Work directly with employers to facilitate a return to work, either on a full-time or modified duty basis.
  • Identify potential for third party recovery, including subrogation, Second Injury Fund or other fund involvement (when applicable) and excess or reinsurance reimbursement.
  • Establish compensability status through case investigation and evaluation and application of jurisdictional statutes and laws.
  • Where litigation is filed, evaluate exposure and work with defense counsel to establish strong defenses, prepare litigation plan of action, set legal reserve and manage litigation over life of claim.
  • Manage diary in accordance with Best Practices and complete tasks to ensure that cases move to the best financial outcome and timely resolution.

• About the company

  Genex is the most experienced managed care provider in the industry.

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