Job Description
Job Description:
We are seeking a detail-oriented and experienced Medical Only Claims Adjuster with a strong background in Pennsylvania Workers' Compensation claims. This role is ideal for a self-motivated professional who excels at managing medical-only claims from inception to resolution, ensuring timely and accurate benefit delivery while maintaining compliance with PA workers' compensation regulations.
- Investigate, evaluate, and manage medical-only workers’ compensation claims in the state of Pennsylvania
- Review and analyze medical reports and treatment plans for appropriateness and compliance
- Coordinate with medical providers, employers, and injured employees
- Ensure timely payments and proper documentation in accordance with PA Workers’ Compensation Act
- Maintain accurate and thorough claim files and system notes
- Monitor claim progress and close claims efficiently and appropriately
- Collaborate with team members, supervisors, and legal staff when needed
Requirements:
- Minimum 2 years of experience handling Medical Only Workers’ Compensation claims in Pennsylvania
- Strong knowledge of PA Workers’ Compensation laws and regulations
- Experience with claim management systems (e.g., Origami, RiskMaster, JURIS, etc.)
- Excellent communication and customer service skills
- Ability to manage multiple claims and meet deadlines
- High attention to detail and organizational skills
Salary/Benefits:
- $50,000 - $55,000 annual base salary plus bonus
- Competitive Medical, Dental, Vision and Life plans
- Medical benefits effective on 1st day of employment
- Employer matching 401(k) plan
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