Medical Only Claims Adjuster (Workers' Compensation)

Location: Remote within the United States; territories excluded. Remote team members must live and work in the United States and have reliable high-speed internet.

Salary: $60,000–$75,000 USD annually

Company

hirify.global uses technology to make commercial insurance more affordable and easier for small businesses.

What you will do

• Independently manage workers’ compensation medical-only claims from setup through closure.
• Investigate claims, make compensability decisions, adjust reserves, administer statutory medical benefits, and comply with applicable regulations.
• Manage medical treatment, utilization review, medical bill payments, claim closure, and escalation of claims that may convert to indemnity claims.
• Mitigate claim exposure and resolve lien claims through appropriate negotiation.
• Support agents, insureds, and business partners with claim guidance, status updates, coverage verification, and loss run reports.
• Identify opportunities to improve claims operations, service standards, handling procedures, and processes.

Requirements

• High school diploma or equivalent required.
• At least one year of workers’ compensation claims experience as a Medical Only Adjuster is required.
• At least one year of experience handling claims in California is required.
• Knowledge and experience in claim adjudication and medical management.
• Strong written and verbal communication, analytical, decision-making, conflict-resolution, and customer service skills.
• Access to reliable high-speed internet while working remotely from the United States.

Nice to have

• Bachelor’s degree or equivalent experience with some college coursework.
• Claims experience in Arizona and Utah.
• Experience with G-Suite tools and collaboration tools such as Slack.

Culture & Benefits

• Remote work for team members based in the United States.
• Comprehensive health plans.
• Generous paid time off.
• 401(k) match.
• Parental and caregiver leave.
• Potential discretionary annual bonuses for eligible team members.