Medical-Only Workers' Comp Claims Adjuster (Hybrid/On-site)

TEEMA Group; Irving (TX); Hybrid; USD 50,000 - 55,000; Full time

Job summary

TEEMA Group is seeking a Workers’ Compensation Medical-Only Claims Adjuster in Irving, Texas. The role handles medical-only claims from intake through closure, with on-site duties and hybrid options outside the DFW metroplex.

You will investigate claims, review medical billing, establish reserves within authority, and communicate with claimants, providers, and clients while adhering to guidelines. Experience with workers’ compensation laws and medical terminology is required.

Qualifications

• 1–3 years of workers’ compensation claims experience.
• Knowledge of workers’ compensation laws and medical terminology.
• Ability to evaluate claim information, medical documentation, and billing.
• Strong judgment to recognize exposure changes and seek guidance.
• Organizational skills and attention to detail; ability to meet deadlines.
• Effective written and verbal communication; state-appropriate licensure.

Responsibilities

• Manage medical-only workers’ compensation claims from intake through closure.
• Conduct timely investigations and gather information for evaluation.
• Determine compensability under state laws and guidelines; escalate when needed.
• Coordinate and monitor medical treatment and billing; authorize within authority.
• Calculate and adjust reserves within limits; maintain diaries and status notes.
• Communicate with claimants, employers, providers, vendors, clients, and staff.
• Monitor for changes in exposure, indemnity, or complexity; refer when necessary.

Skills

Claims experience

Regulatory knowledge

Analytical thinking

Organizational skills

Communication skills

Licensure/Certification

Education

Bachelor's degree (nice to have)

Job description

TEEMA Group is seeking a Workers’ Compensation Medical-Only Claims Adjuster in Irving, Texas. The role handles medical-only claims from intake through closure, with on-site duties and hybrid options outside the DFW metroplex.

You will investigate claims, review medical billing, establish reserves within authority, and communicate with claimants, providers, and clients while adhering to guidelines. Experience with workers’ compensation laws and medical terminology is required.