Medical-Only Claims Adjuster (Hybrid) — Growth & ESOP

CCMSI; Florida; Hybrid; USD 32,000 - 34,000; Full time

Job summary

CCMSI in Maitland, FL is seeking a Medical Only Claim Representative. The role handles medical only claims, maintains files, and supports the claims staff in a hybrid work setting.

Responsibilities include setting up files, reserving funds, reviewing invoices, coordinating medical treatment, and ensuring compliance with standards. Strong phone communication and detail‑oriented work are essential.

Qualifications

• Associate Degree or two years of related business experience.
• Customer‑service oriented mindset with comfort communicating by phone.
• Strong organizational skills and ability to multitask effectively.
• Ability to work efficiently on a computer and manage detailed documentation.
• Proficiency with Microsoft Office applications including Word, Excel, and Outlook.
• Reliable, predictable attendance during assigned business hours.

Responsibilities

• Set up and manage medical‑only claim files in accordance with corporate claim standards and applicable laws.
• Establish reserves and provide reserve recommendations within authorized levels under direct supervision.
• Review and approve medical and miscellaneous invoices on designated claims; negotiate disputed bills or invoices under supervision.
• Request and monitor medical treatment in accordance with corporate claim handling standards.
• Summarize correspondence and medical records in claim system notes and file documentation appropriately.
• Close claim files when appropriate and retrieve closed files for re‑filing as requested.
• Provide ongoing support to claim staff on client service teams.
• Communicate with medical providers, injured workers, and internal partners; frequent phone work is required.
• Ensure compliance with corporate claim handling standards and special client handling instructions.

Skills

Customer service

Organizational skills

Multitasking

Phone communication

Microsoft Office

Education

Associate Degree

Two years experience

Tools

None

Job description

CCMSI in Maitland, FL is seeking a Medical Only Claim Representative. The role handles medical only claims, maintains files, and supports the claims staff in a hybrid work setting.

Responsibilities include setting up files, reserving funds, reviewing invoices, coordinating medical treatment, and ensuring compliance with standards. Strong phone communication and detail‑oriented work are essential.