Medical Only Adjuster
The Worker's Compensation Medical Only Claims Adjuster is responsible for the prompt and effective investigation of worker's compensation claims involving injuries that require medical treatment but no wage loss. Claim adjudication requires interaction with Insureds, claimants, medical providers, and other parties to ensure adequate medical treatment is provided while utilizing Company resources in a cost-effective manner.
• Ability to multitask and prioritize work in a fast-paced environment and manage time effectively
• Investigates losses of low to moderate severity to determine cause, scope, and extent of injury and/or liability for potential subrogation
• Verifies coverage and confirms policy conditions have been met
• Obtains missing information and ensures data integrity for Regulatory reporting
• Communicates effectively with claimants, policyholders, Underwriters, agents, and other internal and external stakeholders
• Authorizes medical treatment and schedules medical appointments.
• Establishes medical reserves, approves medical bills and reviews/requests medical records
• Documents all correspondence, reports, discussions, and decisions in Claim file notes • Knowledge of multiple state jurisdictions (if applicable)
• Obtain appropriate Adjuster licensing (If applicable)
• Performs other related duties as assigned Qualifications Required
• Proficiency with MS Word, Excel, and other business applications
• Demonstrated skills in critical thinking and independent decision making
• State licensing requirements (if applicable)
• Minimum of 2 years handling Medical Only or other Workers Compensation Claims experience
• Basic knowledge of medical conditions, treatment plans and casual relation to occupational injury/illness
No license needed, but preferred.
Looking for at least a high school diploma (preferred).
Hourly position. Salary range of $40,000 - $47,000 annual based on experience.
Location will be Blue Bell or Mount Laurel (Remote for now.)