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Medical Only Claims Specialist - Workers' Compensation
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Job Description
- Req#: R001859
Employer Industry: Workers' Compensation Insurance
Why consider this job opportunity:
- Salary up to $78,759.00 annually + bonus + benefits
- Opportunity for career advancement and growth within the organization
- Flexible work arrangements, including hybrid and remote options
- Comprehensive benefits package including health, dental, vision insurance, and 401(k) with company match
- Supportive and collaborative work environment focused on professional development
- Chance to make a positive impact on the outcomes of work-related injury claims
What to Expect (Job Responsibilities):
- Manage a high-frequency desk primarily focused on medical-only claims
- Conduct thorough investigations and gather relevant facts for claims
- Evaluate claims and determine eligibility for benefits based on established guidelines
- Collaborate with various stakeholders to manage claim costs and promote quality medical care
- Analyze reports and adjust claim strategies as needed to achieve favorable outcomes
What is Required (Qualifications):
- One year of experience in insurance, customer service, claims investigation, legal, rehabilitation, or medical claims processing required
- Must pass the claims adjuster license exam(s) as assigned within 6 months of being hired
- Ability to use logic and sound reasoning to identify alternative solutions for problem-solving
- Strong written and verbal communication skills
- Proficient in the use of laptops, claims management systems, and Microsoft Office suite
How to Stand Out (Preferred Qualifications):
- Bachelor's Degree from an accredited college or university is preferred
- Workers' compensation claims experience and licensure preferred
- Preference for candidates with multiple state claims management experience
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