Senior Medical Only Claims Representative - Workers Compensation

Responsibilities

• Investigate and manage all aspects of a medical only claim, maintaining phone/written contact with all necessary parties.
• Verify coverage, investigate, manage, and resolve medical only claims promptly and accurately.
• Authority to approve or deny payment of medical invoices, and determine case reserves, with up to $10,000 in reserve approval authority.
• Handle medical only claims in Maryland, New Jersey, and Pennsylvania, with the largest volume of claims being Pennsylvania.
• Prioritize tasks and remain calm under pressure.

Qualifications

• At least 2 years of experience handling medical only claims is required.
• Must have current license(s) to adjust workers’ compensation claims in Delaware, Connecticut, or New Hampshire, or willingness to obtain same.
• Excellent communication skills required, in both written and verbal form.
• Must be able to work with accuracy and speed with a variety of internal and external contacts.
• Self-motivated due to the work-from-home nature of the position.
• A high school diploma is required.

Benefits

• Competitive benefits packages for full-time and part-time employees.
• Medical, dental, and vision coverage.
• Wellness plans, parental leave, adoption assistance, and tuition reimbursement.
• Paid Time Off and paid holidays.
• 401(k) plan with company match.
• Employee stock purchase plan.
• Commuter benefits.