Medical Only Workers Compensation Adjuster

Phoenix, Arizona

 

Exciting opportunity as a workers' compensation Medical Only Claims Specialist in Phoenix with great potential for growth. We are expanding our workers’ compensation claims department due to the many new clients selecting National TPA for our unique and results-oriented solution. If you can manage claims in a fast-paced environment with specific customer service requirements, you will want to be part of the Claims Team.

Essential Duties:
• Using established procedures, independently manages a caseload of 175 – 200 WC claims comprised of both non-complex & non-problematic
• Communicate with employers, patients, physicians & attorneys
• Confirm & document coverage
• Prepare & file State forms
• Establish expense & medical reserves.
• Handle requests for treatment & early return to work
• Develop & maintain well documented action plans
• Prepare claim status reports & attend claim reviews (infrequent basis)
• Assure compliance with customer & carrier requirements while following TPA’s Claim Standards.

Education/Training:
• Minimum of two (2) years of experience handling AZ workers compensation claims.
• Comprehensive knowledge of essential practices & procedures to manage WC claims
• Exceptional knowledge & understanding of legal procedures along with WC laws relating to claim investigations, medical treatment along with the associated mandatory reporting requirements
• Computer skills that include proficiency in MS Office, claims software & other applicable web-based programs
• Excellent analytical & interpretive skills
• Work in an organized & proactive manner
• Excellent oral & written communication skills
• Good interpersonal skills that include professional & effective communication with internal & external customers
• WCCA/WCCP Preferred • AZ Adjuster’s License Preferred