Workers' Comp Medical Only Adjuster

Location: Home United States; fully remote

Salary: $49,500–$55,000 per year

Company

hirify.global is a professional services and technology firm supporting insurance and highly regulated businesses with claims, risk, transformation, and operational solutions.

What you will do

• Investigate assigned medical-only workers’ compensation claims through contact with injured workers, employers, physicians, witnesses, and other parties.
• Evaluate compensability, claim exposure, benefit entitlement, medical information, statutes, and case law.
• Set and maintain reserves, provide benefits, complete required state filings, and maintain accurate claim documentation.
• Monitor treatment, review and approve medical bills, authorize services, and coordinate with Nurse Case Managers.
• Coordinate light-duty work and reasonable accommodations with employers and medical providers.
• Identify recovery opportunities, report qualifying claims to excess carriers, participate in client reviews, and negotiate settlements when appropriate.

Requirements

• Prior experience handling workers’ compensation claims, including medical-only claims.
• Experience with Florida workers’ compensation statutes and claim requirements.
• Strong knowledge of medical terminology, procedures, treatment documentation, compensability, reserves, and benefits.
• Experience with claim systems, medical bill review, ISO, reserving tools, subrogation, contribution, indemnification, and excess carrier reporting.
• Strong written and verbal communication, organization, independent judgment, and decision-making skills.
• Proficiency with Microsoft Word, Excel, Outlook, claims management systems, and related business software.

Culture & Benefits

• Fully remote work arrangement for the United States-based role.
• Medical, dental, and vision insurance plans.
• 401(k) plan with employer matching.
• Paid time off, discretionary time off for exempt employees, and paid holidays.
• Life insurance and short- and long-term disability coverage, subject to role and location eligibility.
• Inclusive workplace focused on diversity, professional development, innovation, and client service.