Claims Associate Medical only Examiner

Job Description

Job Description

Job Profile

Job Title: Claims Associate

Location: Remote within Arizona

Hire Type: Contingent

Pay Range: $22 - $24/hr.

Work Model: Remote

Work Shift: Monday-Friday 8 am – 4:30 pm

Recruiter Contact: Sean Craft I [email protected] I 443-345-3305

Nature & Scope:

Positional Overview

We are seeking an experienced Claims Associate – Medical Only Examiner to join our Workers’ Compensation team. In this role, you will be responsible for analyzing and adjudicating lower-level workers’ compensation claims, focusing primarily on medical-only cases and minor lost-time claims . You will ensure compliance with company standards, state regulations, and industry’s best practices, while maintaining a high level of accuracy and customer service.

Role & Responsibility:

Tasks That Will Lead to Your Success

• Adjust medical-only claims and minor lost-time workers’ compensation claims under close supervision.
• Support claims representatives, examiners, and team leaders with larger or more complex claims as needed.
• Process workers’ compensation claims by determining compensability, benefits due, and reserving accuracy.
• File necessary documentation with the appropriate state agencies in a timely manner.
• Communicate claim activity and processing with claimants, clients, and medical providers.
• Ensure claim files are properly documented and claims coding is accurate.
• Process routine payments, prescriptions, and status reports for lifetime or defined-period medical claims.
• Maintain professional and positive client relationships.

Skills & Experience

Qualifications That Will Help You Thrive

• High School Diploma or GED required.
• Arizona workers’ compensation license or certification is a plus.
• Minimum of 2 years of direct claim handling experience or transferable skills in the claims industry required.
• Prior medical-only desk-level handling experience is strongly preferred.
• One (1) year of general office experience required.
• Strong oral and written communication skills.
• Proficient in Microsoft Office products and general PC literacy.
• Analytical and interpretive skills with attention to detail.
• Excellent organizational and time management skills.
• Strong interpersonal skills with the ability to collaborate in a team environment.
• Ability to meet or exceed performance competencies and service standards.