Medical Only – Claim Representative

Medical Only – Claim Representative

Requirements

• Strong written and verbal communication abilities.
• Excellent prioritization, multitasking, and decision-making skills.
• Proficiency in Microsoft Office, including Word, Excel, and Outlook.
• High school diploma or equivalent is required.

Responsibilities

• Managing medical-only workers’ compensation claims in accordance with company standards and applicable laws.
• Establishing and recommending reserves under supervision.
• Approving or negotiating medical invoices and monitoring ongoing treatment.
• Summarizing medical records and correspondence in claim logs.
• Assisting with claim file setup, documentation, and closure.
• Providing clerical and technical support to the claims team.
• Complying with corporate claim standards and special client handling instructions.

Preferred Qualifications

• Familiarity with medical terminology.
• Prior claims handling or insurance experience.
• Adjuster License (Preferred)