# Workers’ Compensation Medical Only Claims Adjuster (Remote)

**Company**: Davies
**Location**: Home, Alabama
**Work arrangement**: remote
**Job type**: full-time
**Category**: Healthcare
**Industry**: Insurance

**Apply**: https://davies.pinpointhq.com/en/postings/02a315a0-97e0-488f-82a3-e0256e3ba3db?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_2d6372f5-84f

## Description

We’re seeking a Workers’ Compensation Medical Only Claims Adjuster who brings strong technical expertise, sound judgment, and a proactive approach to managing indemnity and medical-only claims.

This role manages Workers’ Compensation claims from intake through resolution and may support medical-only claim types depending on the assigned client program. The adjuster investigates, evaluates, and manages claims in accordance with company guidelines, client expectations, and jurisdictional requirements.

## Key Responsibilities

### Claim Ownership & Adjudication

- Manage Workers’ Compensation claims from intake through closure

- Determine compensability and benefit eligibility

- Establish and adjust reserves based on claim exposure

### Investigation & Case Management

- Conduct investigations, including interviews and documentation review

- Develop and execute claim strategies

- Identify opportunities for early resolution

### Medical & Indemnity Management

- Monitor treatment plans and coordinate return-to-work efforts

- Administer indemnity benefits in compliance with jurisdictional requirements

### Litigation Management

- Coordinate with defense counsel on litigated claims

- Support hearings, mediations, and settlements

### Client Communication & Compliance

- Provide timely updates to clients and stakeholders

- Ensure compliance with all state regulations and internal standards

## Skills, Knowledge & Expertise

- Strong knowledge of Workers’ Compensation laws, benefit structures, and claims processes

- Experience managing indemnity payments and return-to-work programs

- Ability to handle multiple claims in a fast-paced environment

- Strong investigative, analytical, and decision-making skills

- Effective negotiation and problem-solving abilities

- Excellent written and verbal communication skills

- Proficiency with claims management systems and related technology

- Active adjuster license(s) or ability to obtain as required

- Active FL license needed

## Preferred Qualifications

- Multi-state claims handling experience

- Experience with EDI reporting and jurisdictional compliance requirements

- Familiarity with nurse case management and medical cost containment strategies

## Benefits

- Medical, dental, and vision plans to support your health and that of your family

- A 401(k) plan with employer matching

- Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees

- Paid holidays

- Life insurance and short-term and long-term disability coverage

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## Skills

### Required
- Workers’ Compensation laws
- claims management systems
- investigative skills
- analytical skills
- decision-making skills
- negotiation skills
- problem-solving skills
- written communication
- verbal communication

### Nice to have
- multi-state claims handling
- EDI reporting
- jurisdictional compliance
- nurse case management
- medical cost containment

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Source: [Apply at davies.pinpointhq.com](https://davies.pinpointhq.com/en/postings/02a315a0-97e0-488f-82a3-e0256e3ba3db?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)