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 effectively while remaining calm and focused

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