Workers' Compensation Medical Only Adjuster

🔥 0 minutes ago

🏖️ New Jersey, Ohio, +1 more states – Remote

🏖️ New Jersey – Remote 🏈 Ohio – Remote 🔔 Pennsylvania – Remote

💵 $45k - $55k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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CCMSI

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1978

🏗️ Construction

🏥 Healthcare

📦 Logistics

Construction • Healthcare • Logistics

CCMSI is a company that provides comprehensive risk management services, focusing on claims management and consulting solutions. They offer services to help organizations mitigate risks, reduce costs, and improve operational efficiency through their expertise in claims handling and risk assessment.

📋 Description

• Manage Pennsylvania Workers' Compensation medical-only claims from assignment through closure • Review claim information and supporting documentation for accurate claim setup and handling • Coordinate and monitor medical treatment activities • Review and process medical bills, invoices, and claim-related documentation • Maintain timely diary management and claim file documentation • Summarize medical records, correspondence, and claim activities in the claim system • Communicate with medical providers, employers, and internal claim partners • Monitor claim activity and identify opportunities for closure or escalation • Assist claim staff with claim support activities and special projects • Maintain compliance with Pennsylvania Workers' Compensation regulations, Corporate Claim Standards, and client-specific instructions • Provide responsive service while maintaining quality and productivity expectations • Support claims from initial assignment through closure within a dedicated carrier program

🎯 Requirements

• Associate degree or two years of related business, insurance, healthcare, claims, customer service, or administrative experience • Knowledge of Pennsylvania Workers' Compensation claims or workers' compensation processes • Strong attention to detail and organization skills • Ability to manage a high-volume workload efficiently and accurately • Strong written and verbal communication skills • Ability to prioritize multiple tasks and deadlines • Proficiency with Microsoft Office applications including Outlook, Word, and Excel • Ability to work independently in a remote environment • Reliable attendance during established business hours • Prior Pennsylvania Workers' Compensation experience preferred • Medical-only claim handling experience preferred • Carrier or TPA claim experience preferred • Knowledge of medical terminology preferred • Experience reviewing medical bills, treatment records, and claim documentation preferred • Experience working within a dedicated client or carrier program preferred • Interest in developing a long-term career in Workers' Compensation claims • Bilingual (Spanish) proficiency highly valued but not required • Must be able to work Monday-Friday, 8:00am-4:30pm EST • CCMSI does not provide visa sponsorship for this position

🏖️ Benefits

• 4 weeks paid time off accruing throughout the year • 10 paid holidays in the first year • Medical insurance • Dental insurance • Vision insurance • Life insurance • Disability insurance • 401(k) • Employee Stock Ownership Plan (ESOP) • Internal training and advancement opportunities • Supportive, team-based work environment • Reasonable accommodations throughout the application and hiring process