Hybrid Medical-Only WC Claims Adjuster (Complex)

Selective Insurance; Charlotte (NC); Hybrid; USD 53,000 - 68,000; Full time

Job summary

Selective Insurance seeks a WC Complex Med Only Adjuster for our Charlotte, NC office on a hybrid schedule. Handles medical-only workers compensation claims across multiple jurisdictions with focus on coverage, compensability, and subrogation potential.

Responsibilities include reserving, investigations, and ensuring regulatory compliance; strong communication with insureds and providers is required. Requires knowledge of WC statutes and medical terminology; college degree preferred and 1–3

Qualifications

• Knowledge of workers compensation statutes, coverage, and case law.
• Excellent written and verbal communication skills.
• Working knowledge of medical treatment related to workers compensation claims.

Responsibilities

• Receives and investigates complex medical-only claims to determine coverage and appropriate action.
• Establishes initial and subsequent reserves on complex medical-only claims with exposure under $30,000.
• Ensures compliance with regulations and maintains accurate data for EDI with state and Medicare.

Skills

Workers' compensation

Medical terminology

Verbal & written communication

Education

College degree preferred

1-3 years claims experience preferred

Job description

Selective Insurance seeks a WC Complex Med Only Adjuster for our Charlotte, NC office on a hybrid schedule. Handles medical-only workers compensation claims across multiple jurisdictions with focus on coverage, compensability, and subrogation potential.

Responsibilities include reserving, investigations, and ensuring regulatory compliance; strong communication with insureds and providers is required. Requires knowledge of WC statutes and medical terminology; college degree preferred and 1–3