Senior Medical Claims Representative – Workers Compensation

Role Overview

• 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