Medical Only Workers' Compensation Claims Adjuster | ...

Our client, a leading provider in the insurance industry, is actively expanding and seeking to hire a skilled Workers' Compensation, Medical Only Claims Adjuster to join their team. As a Medical Only Claims Adjuster, you will be responsible for managing a caseload of NYNJ medical claims resulting from workplace injuries. You will assess and manage claims efficiently, ensuring timely and accurate processing in accordance with policy provisions and legal requirements. This person will have the flexibility to work remotely.Key Responsibilities:Evaluate and process medical-only workers' compensation claims in a timely and accurate municate effectively with claimants, medical providers, and employers to coordinate and confirm treatments and recovery plans.Review and interpret medical reports and records to determine claim validity and appropriate payment of benefits.Maintain and update claim files with notes, evaluations, and decision-making processes.Ensure compliance with state regulations and company policies regarding workers' compensation claims.Collaborate with healthcare providers to monitor and assess ongoing treatments and recovery progress.Resolve claim disputes and negotiate settlements where necessary.Provide exceptional customer service and support to all stakeholders involved in the claims process.Qualifications:3+ years of experience handling Medical Only Workers' Compensation -depth knowledge of Workers' Compensation laws in New York and New Jersey.Proficient understanding of medical terminology and care procedures.Excellent organizational and communication skills.Proficiency in claims management software and systems.Ability to work independently in a remote setting.Bachelor's degree in a relevant field is preferred.Salary & Benefits:$65,000 to $80,000 annual base salary (depending on experience).Comprehensive benefits including health, dental, vision, and life insurance.The opportunity to work remotely.401(k) plan with company match.Career development and continuous learning opportunities.

Created: 2025-03-12