Medical Only Claims Adjuster
Core
Manage workers' compensation medical-only claims from setup to closure, focusing on medical management, exposure mitigation, and favorable outcomes for small business customers.
Role type
Medical-only claims adjuster (workers' compensation)
Builds
Claim files and customer service experiences for small business clients
Domain
Insurance / Workers' Compensation
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
workers' compensation claims adjudication, medical management, reserve setting, lien resolution, statutory compliance, utilization review
Preferred skills
experience in California, Arizona, or Utah, G-Suite tools, Slack, claim analysis
Technologies
G-Suite, Slack
Responsibilities
Handle all aspects of medical-only claims from setup to closure, conduct 2-point contact investigations, mitigate claim exposure, determine compensability decisions, set and adjust reserves, administer statutory medical benefits, resolve liens, provide claim status and coverage verification to agents and insureds, improve claims operations and processes.
Seniority
Entry-level to Junior, hands-on IC
