Claims Adjuster- Medical Only

Dallas, Texas (US)

 

Innovative employee friendly Claims’ Third Party Administrator (TPA) has a brand new opening for a customer centric up and coming Workers’ Compensation Medical Only Adjuster looking to fast track their career.  TX Workers' Compensation Adjuster License Required.   Position will be onsite (flexible M-F work schedule) at TPA's  contemporary centrally located Dallas Branch.  File counts are kept to a minimum with helpful Administrative and Supervisory staff and user friendly efficient software systems.  Qualified Applicants MUST have recent direct Medical Only Claims’ handling experience and/or be a Claims Assistant who has recent direct experience processing medical payments, calling on medical providers and exposure to medical claims’ forms.

  • With supervision, you will evaluate claimant eligibility, communicate with attending physician and employer and injured worker
  • Work with both the claimant and their physician to medically manage the claim from initial medical requests to reviewing and evaluating on going medical information.
  • Work directly with employers to facilitate a return to work either on a Full-time or modified duty basis
  • Provide consistent customer service to both our customers and claimants through timely responses to all inquiries, telephone calls and e­mails while delivering on service commitments
  • Manage both new claims as well as open claims equally.
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Requirements:

  • Organized, detailed, articulate strong verbal and written communication skills
  • Self- motivated and can function without constant supervision and direction
  • Team player who works well with a team and with the employer and employees
  • Career oriented
  • TX Adjusters' License, Required exposure to OK & AR is a plus.