Remote Medical Claims Specialist (Workers' Comp)

PMA Companies; Northern (KY); Hybrid; USD 58,000 - 73,000; Full time

Job summary

PMA Companies is hiring an Associate Claims Specialist for Medical-Only Workers Compensation. This remote role focuses on medical-only and limited lost time claims, handling first notices of loss, authorizing treatment, and ensuring regulatory compliance across jurisdictions.

The position requires at least a high school diploma and 1+ year of workers compensation claims handling, with a license obtainable within 90 days in mandated states.

Qualifications

• High school diploma or equivalent is required.
• One or more years of Workers Compensation claims handling experience.
• Ability to obtain or maintain state adjusting licenses within 90 days of employment.

Responsibilities

• Contact accounts on First Notices of Loss to obtain missing information for file setup.
• Process payments, answer calls, and authorize treatment for Medical Only claims.
• Maintain a diary and complete contacts within 24 hours of assignment.
• Determine treatment appropriateness and causally relate to the injury.
• Direct treatment to network physicians when appropriate.
• Refer subrogation or permanency claims to Supervisor.
• Ensure compliance with jurisdictional requirements for Medical Only claims.

Skills

Attention to detail

Organization

Verbal and written communication

Independent work

Education

High School Diploma or equivalent

Tools

MS Excel

MS Word

Job description

PMA Companies is hiring an Associate Claims Specialist for Medical-Only Workers Compensation. This remote role focuses on medical-only and limited lost time claims, handling first notices of loss, authorizing treatment, and ensuring regulatory compliance across jurisdictions.

The position requires at least a high school diploma and 1+ year of workers compensation claims handling, with a license obtainable within 90 days in mandated states.