Workers' Comp Medical Only Adjuster

Davies
United States
Workplace: RemoteFull timeUSD 49,500 - 55,000 annuallyFunction: Healthcare (Clinical, Medical, Wellness)Skills: ["Written communication","Verbal communication","Organizational skills","Independent judgment","Decision-making"]

Investigate and manage assigned workers’ compensation medical-only claims by contacting injured workers, employers, physicians, and witnesses. Evaluate claim details, medical information, and applicable statutes to determine compensability and claim value, set and maintain appropriate reserves, and ensure accurate documentation and diaries. Review and approve medical bills, authorize medical services, coordinate with nurse case managers for treatment monitoring, handle impairment ratings, pursue recoveries, and provide responsive client service.

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Davies
Davies
1 day ago

Workers' Comp Medical Only Adjuster

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Source: Company careers pageValidated by: Fursa AI
Last checked: 12 hours agoStatus: Live

Job Summary

Investigate and manage assigned workers’ compensation medical-only claims by contacting injured workers, employers, physicians, and witnesses. Evaluate claim details, medical information, and applicable statutes to determine compensability and claim value, set and maintain appropriate reserves, and ensure accurate documentation and diaries. Review and approve medical bills, authorize medical services, coordinate with nurse case managers for treatment monitoring, handle impairment ratings, pursue recoveries, and provide responsive client service.
Location: United States
Workplace: Remote
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)

Key Responsibilities

  • •Investigate assigned workers’ compensation claims by contacting injured workers, employers, physicians, witnesses, and other parties.
  • •Evaluate claim details, applicable statutes, case law, and medical information to determine compensability and claim value.
  • •Set and maintain appropriate reserves throughout the life of the claim using tools, guidelines, and company practices.
  • •Review, document, and approve medical bills for payment within required timeframes; authorize appropriate medical services.
  • •Maintain regular contact to support claim progression and customer service, including coordinating light duty and reasonable accommodations, reviewing impairment ratings, and negotiating settlements when appropriate.

Pay and Benefits

Salary: USD 49,500 - 55,000 annually
Perks:Health InsuranceDentalVision401kPaid LeavePaid HolidaysLife InsuranceDisability InsurancePaid Parental

Key Requirements

  • •Prior experience handling workers’ compensation claims.
  • •Working knowledge of workers’ compensation laws, rules, procedures, and claim handling practices.
  • •Strong understanding of medical terminology, medical procedures, and treatment documentation.
  • •Ability to evaluate compensability, claim exposure, reserves, and benefit entitlement.
  • •Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and ability to learn claims management systems.
Experience:Workers’ compensationMedical-only claimsTPA
Skills:Written communicationVerbal communicationOrganizational skillsIndependent judgmentDecision-making
Tech Stack:Microsoft Office SuiteMicrosoft WordMicrosoft ExcelMicrosoft OutlookClaims management systemsISOWorkers’ compensation reserving tools

Company Brief

Davies
Davies is a specialist professional services and technology firm delivering claims, underwriting, and risk solutions to insurers, reinsurers, brokers and regulated businesses globally, with major capabilities in claims management, forensics, and digital transformation.
Industry: Consulting
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Established Company
Valuation: Unicorn (USD 1B+)
Funding: Private Equity Backed
Headquarters: City of London, United Kingdom
Founded: 1968
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