Medical Claims Adjuster

Claims Adjuster – Gallagher Introduction

At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate. You’ll be backed by our digital ecosystem: a client‑centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips.

Here, you’re not just improving clients’ risk profiles, you’re building trust. You’ll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve.

• Process a case load of medical‑only workers’ compensation claims
• Adjudicate a high volume of medical bills in accordance with regulations, policies, procedures, and guidelines
• Meet production and quality standards
• Provide exceptional customer service to members, claimants, medical providers, and vendors
• Prepare professionally written correspondence
• Conduct thorough investigations and determine compensability of claims
• Engage in medical case management
• Maintain appropriate case reserving, electronic claim notes, and plan of action
• Participate in in‑person meetings and claims reviews with members
• Perform follow‑up on open and pending claims/bills to achieve conclusion
• Adhere to established best practices, procedures, statutes, regulation, and laws

• State of Arizona P & C Adjuster’s License
• WCCP and/or AIC designation (a plus)
• Strong work ethic, initiative, and motivation
• Knowledge of CPT, HCPCS, revenue, and ICD‑9/10 codes
• Knowledge of HCFA, UB, RX, and dental claim forms
• Thorough knowledge of medical terminology
• Proficiency with Excel, Word, and general office software systems
• Excellent time‑management and organization skills with high attention to detail
  
  Exceptionally follow‑up and customer‑service skills
• Excellent communication skills—both verbal and written
• Ability to work well under pressure and multi‑task in a fast‑paced environment

High school diploma and 3 years related claims experience required. Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certifications per local requirements. Knowledge of accepted industry standards and practices. Computer experience with related claims and business software.

Bachelor’s Degree.

Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing, embrace new challenges. Analytical skill necessary to make decisions and resolve issues inherent in handling of claims. Ability to successfully negotiate the settlement and disposition of claims, including the ability to interpret related documentation.

We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to, previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours.

On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(k) and Roth options
• Tax‑advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave

• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall well‑being
• Charitable matching gift program
• And more…
• The benefits summary above applies to full‑time positions.…