Claims Administrator
Core
Manage medical-only Workers' Compensation claims from start to finish, including evaluation, documentation, and resolution.
Role type
Claims Administrator (Workers' Compensation)
Builds
Medical-only claim resolutions and state EDI filings
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
claim evaluation, medical documentation, state EDI filing, Medicare compliance, subrogation identification, performance benchmarking
Preferred skills
prior claims or insurance experience, attention to detail, organization
Responsibilities
Review and evaluate medical-only claims to understand incident details; Communicate with injured workers, medical providers, and clients; Document claim activity accurately; Make timely decisions to resolve claims; Submit state EDI filings and ensure Medicare compliance; Identify subrogation opportunities; Meet performance benchmarks for contact, reserving, and claim closure.
