Workers' Compensation Medical Only Adjuster

This is a fully remote position, open to applicants in New Jersey, +2 more states.

📋 Description

• Oversee the management of medical-only claims under Pennsylvania Workers' Compensation from the initial assignment to final closure.

• Assess claim information and relevant documentation to ensure accurate setup and handling of claims.

• Coordinate and oversee medical treatment processes.

• Evaluate and process medical bills, invoices, and documentation related to claims.

• Ensure timely management of diaries and documentation within claim files.

• Summarize medical records, correspondence, and claim activities within the claims system.

• Engage in communication with medical providers, employers, and internal claim partners.

• Track claim activities and identify potential opportunities for closure or escalation.

• Assist claim staff with support activities and special projects related to claims.

• Uphold compliance with Pennsylvania Workers' Compensation regulations, Corporate Claim Standards, and specific client instructions.

• Deliver responsive service while adhering to quality and productivity standards.

• Support claims from the initial assignment to closure within a designated carrier program.

⛳️ Requirements

• An associate degree or two years of relevant business, insurance, healthcare, claims, customer service, or administrative experience.

• Familiarity with Pennsylvania Workers' Compensation claims or associated processes.

• Excellent attention to detail and organizational skills.

• Capability to efficiently and accurately manage a high-volume workload.

• Strong written and verbal communication abilities.

• Skill in prioritizing multiple tasks and meeting deadlines.

• Proficiency in Microsoft Office applications, including Outlook, Word, and Excel.

• Ability to work independently in a remote setting.

• Dependable attendance during designated business hours.

• Previous experience in Pennsylvania Workers' Compensation is preferred.

• Experience handling medical-only claims is preferred.

• Previous experience with carrier or TPA claims is preferred.

• Knowledge of medical terminology is preferred.

• Experience in reviewing medical bills, treatment records, and claim documentation is preferred.

• Previous experience in a dedicated client or carrier program is preferred.

• Interest in pursuing a long-term career in Workers' Compensation claims.

• Bilingual proficiency in Spanish is highly valued but not required.

• Availability to work Monday through Friday, from 8:00 am to 4:30 pm EST.

• Please note that CCMSI does not provide visa sponsorship for this position.

🏝️ Benefits

• Four weeks of paid time off accrued throughout the year.

• Ten paid holidays in the first year.

• Medical insurance coverage.

• Dental insurance benefits.

• Vision insurance options.

• Life insurance protection.

• Disability insurance coverage.

• 401(k) retirement plan.

• Employee Stock Ownership Plan (ESOP).

• Opportunities for internal training and career advancement.

• A supportive, team-oriented work environment.

• Reasonable accommodations available throughout the application and hiring process.