Medical Only Claims Specialist

This is a fully remote position, open to applicants in Oregon.

📋 Description

• Oversee uncomplicated and straightforward medical-only Workers’ Compensation claims with close supervision.

• Receive Workers’ Compensation claims and verify policy coverage as well as acknowledgment of claims.

• Assess the validity and compensability of claims.

• Set reserves and authorize payments in accordance with established reserving authority limits.

• Update customers, claimants, and clients on claim status.

• Follow client and carrier guidelines diligently.

• Engage in claims reviews as necessary.

• Support other claims professionals with more intricate or challenging claims.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• Bachelor’s degree or a combination of education and relevant experience.

• At least 1 year of industry experience and claims handling.

• Experience in Workers’ Compensation is essential.

• Licensed as required by jurisdiction.

• Exceptional customer service abilities.

• Strong written and verbal communication skills.

• Quick learner; able to develop knowledge and understanding of claims practices, relevant statutes, and medical terminology.

• Capability to identify, analyze, and resolve issues.

• Proficient in computer skills and technical aptitude for utilizing Microsoft Office, including Excel spreadsheets.

• Robust interpersonal, time management, and organizational skills.

• Ability to work independently as well as collaboratively within a team environment.

🏝️ Benefits

• Medical (HDHP) with Pharmacy.

• Dental insurance.

• Vision insurance.

• Long Term Disability.

• Health Savings Account.

• Flexible Spending Account options.

• Life Insurance.

• Accident Insurance.

• Critical Illness Insurance.

• Pre-paid Legal Insurance.

• Parking and Transit FSA accounts.

• 401K.

• ROTH 401K.

• Paid time off.

• Opportunities for career advancement.

• Supportive workplace culture.

• Equal Opportunity Employer.

• Drug-free workplace.