Senior Medical Claims Representative – Workers Compensation

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Job Description:

  • Investigate and manage all aspects of a medical only claim, maintaining phone/written contact with all necessary parties
  • Verify coverage, investigate, manage, and resolve medical only claims promptly and accurately
  • Authority to approve or deny payment of medical invoices, and determine case reserves, with up to $10,000 in reserve approval authority
  • Required to handle medical only claims in Maryland, New Jersey, and Pennsylvania with the largest volume of claims being Pennsylvania

Requirements:

  • At least 2 years of experience handling medical only claims is required
  • Prefer candidates have current license(s) to adjust workers’ compensation claims in Delaware, Connecticut, or New Hampshire or willingness to obtain same
  • Excellent communication skills required, in both written and verbal form
  • Must be able to work with accuracy and speed with a variety of internal and external contacts
  • Must be self-motivated as this is a work-from-home position
  • A high school diploma is required

Benefits:

  • medical, dental, and vision coverage
  • wellness plans
  • parental leave
  • adoption assistance
  • tuition reimbursement
  • Paid Time Off
  • paid holidays
  • 401(k) plan with company match
  • employee stock purchase plan
  • commuter benefits
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