Senior Claims Analyst

Enlyte•Egg Harbor Township, NJ

About The Position

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.

Requirements

High School diploma required
At least 5-6 years of experience handling workers’ compensation claims required; more experience may be required depending upon complexity of claim pending.

Nice To Haves

Associate’s or Bachelor’s degree preferred, or five or more years of equivalent work experience required in an insurance, medical/health or legal related industry
Completion of Workers’ Compensation training courses internally and/or externally in all significant areas affecting Workers’ Compensation claims handling and practices.
Workers’ Compensation licenses, certifications, awards preferred.

Responsibilities

Manage complex, high-exposure, and catastrophic workers’ compensation claims from inception through closure.
Determine compensability and coverage eligibility through investigation, policy analysis, and application of jurisdictional statutes.
Coordinate and oversee medical treatment, working closely with injured workers, physicians, nurse case managers, and other medical providers.
Facilitate timely return-to-work programs, including modified-duty and full-duty placements in collaboration with employers.
Ensure compliance with all statutory requirements, including timely payment, denial, and administration of benefits.
Evaluate exposure and maintain accurate claim reserves, documenting rationale and adjusting reserves throughout the life of the claim.
Manage litigated claims, partnering with defense counsel to develop strategies, assess exposure, and control legal costs.
Identify and pursue recovery opportunities, including subrogation, Second Injury Fund reimbursements, excess insurance, and reinsurance recoveries.
Apply appropriate offsets and credits, including disability, pension, and other available reductions to claim costs.
Maintain proactive claim management practices, including diary management, timely follow-up, and resolution-focused action plans.
Deliver exceptional customer service and communication, serving as a trusted resource for claimants, employers, clients, attorneys, and internal stakeholders.
Drive effective claim resolution and closure, meeting organizational performance goals while achieving the best possible financial and operational outcomes.