Medical-Only Workers' Comp Claims Specialist (Hybrid)

Berkshire Hathaway Guard; Wilkes-Barre (Luzerne County); Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Hybrid schedule

Generous PTO

Benefits from day one

401(k) with matching

Tuition reimbursement

Longevity bonuses

Job summary

Berkshire Hathaway GUARD Insurance Companies in Wilkes-Barre, PA, is hiring a Medical Claims Representative. You will manage Workers' Compensation medical-only claims from initial report through resolution, coordinating with injured workers, employers and medical providers in a fast-paced hybrid environment.

The role requires proficiency with Microsoft Office, strong communication and attention to detail, plus the ability to interpret medical and legal terminology.

Qualifications

• Proficiency with Microsoft Office applications and other business technologies.
• Strong communication, organizational, and customer service skills.
• Ability to understand and apply medical and legal terminology related to Workers' Compensation claims.
• Strong attention to detail.
• Ability to learn new technology and systems.
• Licensing support for state adjuster licenses; company will assist with licensing.

Responsibilities

• Manage Workers' Compensation medical-only claims from initial report through resolution.
• Determine compensability and ensure timely delivery of benefits.
• Coordinate medical treatment and facilitate early return-to-work efforts.
• Review and process medical bills for payment.
• Serve as a liaison between injured workers, employers, and medical providers.
• Provide guidance regarding Workers' Compensation processes and claim management.
• Maintain accurate claim documentation and comply with applicable regulations and company procedures.

Skills

Microsoft Office

Communication skills

Organizational skills

Customer service

Attention to detail

Learning mindset

Education

High School Diploma or GED

Job description

Berkshire Hathaway GUARD Insurance Companies in Wilkes-Barre, PA, is hiring a Medical Claims Representative. You will manage Workers' Compensation medical-only claims from initial report through resolution, coordinating with injured workers, employers and medical providers in a fast-paced hybrid environment.

The role requires proficiency with Microsoft Office, strong communication and attention to detail, plus the ability to interpret medical and legal terminology.