Licensed Medical Claims Adjuster

A company is looking for a Medical Only Workers' Compensation Adjuster.

Key Responsibilities

Determine coverage eligibility and investigate claims by interviewing involved parties

Manage medical only claims, ensuring timely payment of appropriate medical bills

Deny claims that do not meet compensability criteria and defend those decisions when challenged

Required Qualifications

Six years of experience in adjudicating medical only claims or related fields

High School diploma or GED; Bachelor's degree preferred

Must possess a strong understanding of insurance operations and business acumen

Licensed Claims Examiner or ability to obtain a license within 120 days

Proficiency in MS Office Suite and other business-related software