IAIABC Member Spotlight

Each month, the IAIABC highlights one of its member organizations, asking about what the organization does; what challenges it sees workers' compensation facing; and why they're involved with the IAIABC. Find past member spotlights here. 

IAIABC: Please provide an organizational overview (number of employees, years in business, vision)

Tom Kerr, Director of Public Relations, Marketing, Enlyte: 

Enlyte is a P&C industry leader, providing claims technology innovations and connectivity solutions, specialty networks, case management, pharmacy benefit and disability management services. With 80 years’ experience, Enlyte’s 5,000+ employees serve over 2,000 entities, including a majority of Fortune 500 employers. Enlyte leverages its portfolio of solutions to simplify processes and improve outcomes for auto, workers’ compensation, and disability claims.

IAIABC: How does your organization serve the workers’ compensation industry? 

TK: Enlyte provides industry-leading solutions in the workers’ compensation industry designed to lower costs for employers, support carriers and TPAs, and ultimately allow injured employees to return to work effectively and efficiently. Enlyte does this through our integrated services which include:
•    the largest directly contracted national health care network in the industry
•    a cutting-edge medical bill review platform using advanced technology to optimize bill processing for claims organizations
•    a pharmacy bill management solution with clinical supervision and unique technology to deliver optimal outcomes
•    a wide range of clinical solutions including the largest and most experienced case management program in workers’ comp
•    strong specialty solutions including a robust physical medical management network, home health, durable medical equipment and diagnostic services

Enlyte supports injured employees and payers through every step of the claims journey to promote the best possible outcome for all parties. Enlyte team members are proud to continue our strong tradition of involvement with the IAIABC, serving as thought leaders, EDI specialists, and partners providing important solutions in the industry.

IAIABC: What do you see as some of the major challenges the industry is facing, and how can we as a community address them? 

TK: One of the biggest challenges the P&C industry faces is the impact of government policy changes, especially tariffs on medical supplies, which threaten supply chains and could raise costs and limit access to medications. Proposed Medicaid cuts of $880 billion over 10 years may further strain providers and shift costs to other payer systems like workers’ comp. Ongoing legislative shifts, such as moves toward value-based care and the adoption of new technologies, create additional uncertainty for the industry. To address these issues, leaders should advocate for smarter tariff policies, use data-driven strategies to manage costs, and collaborate across the health care ecosystem to shape fair and effective policies.

IAIABC: Are there any projects/programs/initiatives going on at your organization that you are particularly excited or enthusiastic about?

TK: The opportunity of leveraging Gen AI in claims management is obvious, not just in driving productivity improvements but also improving quality and service delivery. However, building a framework for AI systems developed to meet the needs of our industry requires a rigorous management approach that balances responsibility with the desire to move fast.

At Enlyte, we are most proud of our advances in developing technology that takes the powerful ability of AI in leveraging data (be it medical billing data, repair information, photos of damaged vehicles or images from litigation demands) to improve task automation and enable advanced decision support. This empowers claims professionals to improve their efforts in helping individuals return to work, optimal health, or get back on the road. We’ve built into these programs our strict guidelines for ensuring careful stewardship of sensitive health data, including nuances of our business to help ensure such programs follow ethical, transparent, and accountable practices, which include developing and implementing policies and procedures promoting data privacy, model validation, and responsible use.

IAIABC: What's an interesting fact about your organization that most people don't know?

TK: Enlyte is well known in the industry but some may not realize the extensive history of our organization. Enlyte has a combined history of three distinct businesses (Mitchell, Genex and Coventry) that have come together to create a more powerful, integrated entity. This creates an unparalleled depth of P&C expertise spanning medical bill review, pharmacy benefit management, clinical services, data analytics, regulatory compliance, provider and specialty networks, and corporate strategy. Enlyte leverages its unique foundation to bring forward sophisticated analytics, proactive policy analysis, and innovations in claims management, making us a major thought leader in the workers’ comp, auto casualty and disability industries.

IAIABC: Why is your organization a member of the IAIABC? What would you tell others about the benefits of membership?

TK: Enlyte has been a member, and proudly served the mission, of the International Association of Industrial Accident Boards and Commissions for over 20 years. This partnership provides invaluable opportunities for learning, leadership development and industry networking, enabling us to both enhance and share our expertise in the workers’ comp sector.

Our organizations share a common mission: reducing harm and supporting recovery from work-related injuries. This natural alignment makes our collaboration particularly meaningful, and we stand committed to education and driving innovation within the industry.

A key benefit of our active membership is contributing to identifying medical issues impacting workers’ compensation, assisting in the creation of comparable approaches to working with data, and the development and implementation of consistent standards across workers’ compensation policy, regulations, and administration.  

Enlyte team members have been leaders in the development and implementation of vitally important electronic standards, including the IAIABC Workers’ Compensation Electronic Medical Billing Model Rule, and Billing and Payment National Companion Guide, which ensures alignment with national electronic health care transaction standards such as X12 and NCPDP. Involvement with the IAIABC allows the workers’ compensation industry to leverage the efficiencies and cost effectiveness of medical billing and payment standards utilized in the health care industry.  

Two additional electronic standards development and implementation Enlyte has contributed to are the EDI Medical State Reporting and EDI Claims (FROI/SROI) programs. Enlyte team members were involved in the early stages of development for numerous IAIABC electronic standards products and assist in jurisdiction implementations. We continue to collaborate with the IAIABC in maintaining current standards while brainstorming future standards to support the industry as it evolves. 

Previous Member Spotlights

2025 Member Spotlights

WCF Insurance - January 2025
Washington State Department of Labor and Industry - March 2025
Linea Solutions: Special Edition - April 2025