Medical-Only Claims Specialist

CCMSI; Reno (NV); On-site; USD 45,000 - 50,000; Full time

Benefits offered by this job

PTO 4 weeks

Paid holidays

Benefits package

401K ESOP

Career growth

Team culture

Job summary

CCMSI is hiring a Medical Only Claim Representative in Reno, NV to manage designated medical‑only claims and support to claim staff. The role may serve as a training position toward promotion to an intermediate claim level. Expected to maintain high quality and compliance with corporate standards.

Requirements include an Associate degree or two years of related business experience, strong phone communication, solid organization, and proficiency with MS Office. Attendance reliability is 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

Phone communication

Organizational skills

Documentation

MS Office

Attendance reliability

Education

Associate degree or 2 years of related business experience

Tools

MS Office

Job description

CCMSI is hiring a Medical Only Claim Representative in Reno, NV to manage designated medical‑only claims and support to claim staff. The role may serve as a training position toward promotion to an intermediate claim level. Expected to maintain high quality and compliance with corporate standards.

Requirements include an Associate degree or two years of related business experience, strong phone communication, solid organization, and proficiency with MS Office. Attendance reliability is essential.