Medical Claims Investigator & Processor

Offres d’emploi Crawford - Mondiales; Tampa (FL); On-site; USD 34,000 - 61,000; Full time

Benefits offered by this job

Medical, Dental and Vision Plans

401(k) Retirement Plan

Tuition Assistance

Paid Parental Leave

Job summary

Crawford & Company seeks a Field Sr. Administrative Support in the USA Field to administer and resolve non-complex short-term medical claims and to close files promptly within delegated authority.

The role involves investigating coverage, reserving, and processing payments up to $2,500, while coordinating with claimants, medical professionals, and team members. A college degree and valid licenses are required, with strong communication skills emphasized.

Qualifications

• College degree or the equivalent of education and experience.
• Knowledge of claims terminology and processing gained through industry experience.
• Understanding of basic medical terminology and tests for claimed conditions.
• Effective and diplomatic oral and written communication skills.
• Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster/supervisory/management level; valid drivers license; continuing education requirements.

Responsibilities

• Investigates claims to confirm coverage and liability, and determine damages.
• Verifies policy coverage and notifies insured of issues; establishes reserves as needed.
• Identifies wage loss expenses on medical claims.
• Documents medical reports and interacts with claimants and medical professionals.
• Approves payments of medical bills up to $2,500 after compensability is determined.
• Maintains status reports and completes required forms and documentation.

Skills

Communication skills

Customer focus

Licensing basics

Education

College degree

Associate in Claim designation

Job description

Crawford & Company seeks a Field Sr. Administrative Support in the USA Field to administer and resolve non-complex short-term medical claims and to close files promptly within delegated authority.

The role involves investigating coverage, reserving, and processing payments up to $2,500, while coordinating with claimants, medical professionals, and team members. A college degree and valid licenses are required, with strong communication skills emphasized.