Workers' Compensation Claims Specialist

Managing a high-frequency desk, the full-time Medical Only Claims Specialist, Workers' Compensation will investigate, evaluate, and determine compensability for medical-only claims across multiple jurisdictions while working remotely. Key responsibilities Gathers relevant facts through thorough claim investigations and performs three-point contacts with involved parties Decides claim outcomes using established policies and guidelines, and evaluates action plans for managing benefits Collaborates with various stakeholders to promote quality medical care and manage claims costs effectively Required qualifications Bachelor's Degree from an accredited college or university is preferred One year of experience in insurance, claims investigation, or medical claims processing is required Workers' compensation claims experience and licensure preferred Must pass the claims adjuster license exam(s) within 6 months of hire Preference for candidates with multiple state claims management experience