Job Description:
A top insurance company is looking to onboard a medical adjuster to their team. This person investigates claims by reviewing accident reports, speaking with injured employees, coordinating with medical providers, evaluating medical records and billing, determining compensability, and approving or adjusting claim payments in compliance with state regulations and fee schedules. The adjuster also monitors recovery progress, maintains detailed claim documentation, and delivers exceptional service while working toward timely claim closure.
Day to Day:
Manage workers' compensation medical-only claims in Virginia and Tennessee.
Review accident reports from employers
Calling the injured employee to hear their side of the incident.
Speaking with medical providers about treatment plans.
Verifying whether the injury is work-related and compensable.
Review medical bills and records
Approve, deny, or adjust payments.
Ensure bills comply with state fee schedules.
Monitor employees' recovery progress.
Update claim notes & close claims!
Must Haves:
1-2 years of experience medical adjusting in VA and TN
Plusses:
Bachelor's Degree