Claims Representative - Medical Only
HybridWilkes-Barre, Pennsylvania, United States
Job Summary
Manage Workers' Compensation medical-only claims from initial report through resolution, determining compensability and ensuring timely delivery of benefits. Coordinate medical treatment to facilitate early return-to-work efforts, review and process medical bills for payment, and serve as a liaison between injured workers, employers, and medical providers. Provide guidance regarding Workers' Compensation processes and claim management while maintaining accurate documentation and complying with applicable regulations. Requires an active adjuster license or ability to obtain one, with a hybrid schedule of two days remote and three in-office.
Required Qualifications
- Proficiency with Microsoft Office applications and other business technologies
- Strong communication, organizational, and customer service skills
- Ability to understand and apply medical and legal terminology related to Workers' Compensation claims
- Strong attention to detail
- Ability to learn new technology and systems
- High School Diploma/GED
- Active adjuster license
- Willingness and ability to obtain and maintain all required state licenses
Desired Qualifications
- Additional education
- Relevant claims experience
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