Medical-Only Claims Specialist

Cannon Cochran Management Services, Inc.; Irvine (CA); On-site; USD 45,000 - 55,000; Full time

Benefits offered by this job

4 weeks PTO

Comprehensive benefits

401(k) + ESOP

Career growth

Team-based culture

Job summary

The CCMSI Medical Only Claim Representative in Irvine, CA handles designated medical-only claims and supports claim staff. This role may serve as a training step toward promotion to an intermediate level position, with emphasis on accuracy, timeliness, and client service.

You will set up files, manage reserves under supervision, review invoices, coordinate medical treatment, and maintain detailed claim notes. Frequent phone contact with providers, workers, and internal partners is expected.

Qualifications

• Associate Degree or two (2) 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

Attention to detail

Phone communication

Multitasking

Education

Associate Degree or 2 years related experience

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

The CCMSI Medical Only Claim Representative in Irvine, CA handles designated medical-only claims and supports claim staff. This role may serve as a training step toward promotion to an intermediate level position, with emphasis on accuracy, timeliness, and client service.

You will set up files, manage reserves under supervision, review invoices, coordinate medical treatment, and maintain detailed claim notes. Frequent phone contact with providers, workers, and internal partners is expected.