Medical Claims Adjuster

Position Overview

The Medical Only Claims Adjuster manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of the Claims Department and Cor Vel. This is a hybrid position reporting to Dallas, Texas.

• Receives claims, confirms policy coverage and acknowledgement of the claim
• Determines validity and compensability of the claim
• Establishes reserves and authorizes payments within established reserving authority limits
• Communicates claim status with the customer, claimant and client
• Adheres to client and carrier guidelines and participates in claims review as needed
• Assists other claims professionals with more complex or problematic claims as necessary
• Additional duties as assigned

• Excellent customer service skills
• Excellent written and verbal communication skills
• Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
• Ability to identify, analyze and solve problems
• Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
• Strong interpersonal, time management, and organizational skills
• Ability to work both independently and within a team environment

• Bachelor's degree or a combination of education and related experience
• Minimum of 1 year industry experience and claim handling
• WC experience required
• Licensed as required jurisdictionally

Pay Range: $16.36 - $26.31 per hour

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

Cor Vel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.