Claims Adjuster - Medical Only

Medical Claims Adjuster

It is the responsibility of the Medical Claims Adjuster to manage medical only workers compensation claims offering good customer service to all involved parties and seeing claims through to resolution.

Job Summary

• Analyze First Reports and make contacts with involved parties of claim to conduct a thorough claims investigation
• Manage a large volume of Medical Only Claims
• Handle some minor claims with lost time and or impairment benefits
• Maintain file diaries until  resolution
• Conduct reserve analysis
• Recognize and pursue medical recovery and treatment
• Make timely medical payments
• Participate in Claims Roundtables and conference claim reviews for specific accounts
• Best Practice Compliance

Job Requirements

• College degree preferred
• Valid NC Adjuster’s License required
• Up to two or more years work experience in a claims environment, preferred
• Ability to operate independently and effectively.
• Demonstrated proactive approach to service for both external and internal customers.
• Excellent interpersonal skills and ability to maintain positive approach.
• Excellent time management and organizational skills.
• Have some adjustment and negotiation skill set, coupled with a working knowledge of Product Standards and state laws and regulations
• Good analytical skills
• Excellent written and oral communication skills

We Offer:

• Competitive salary with a benefit package that includes health, vision and dental coverage, life & AD&D insurance, disability, flexible spending, 401K plan with company match, paid time off, paid company holidays.