Remote Medical-Only Claims Examiner (California)

Gallagher; Corona (CA); Remote; Confidential; Full time

Benefits offered by this job

Competitive pay

Benefits package

Career development

People-first culture

Global reach local impact

Job summary

Gallagher is hiring a Medical Only Claims Examiner in California. The role focuses on administering Medical Only workers' compensation claims with emphasis on accuracy, regulatory compliance, and excellent client service.

Remote work within California with opportunities for growth and impact. The candidate will handle timely processing, benefits administration, and documentation while collaborating with a team committed to integrity and client trust.

Qualifications

• Bachelor's degree required.
• Minimum of 3 years claim handling experience in brokerage or insurance.
• California IEA class course completion preferred.

Responsibilities

• Process and administer Medical Only workers' compensation claims.
• Perform data entry and establish all new Medical Only claims.
• Conduct claim investigations and verify injury details and status.
• Review DWC notices, correspondence, and required documentation.
• Calculate and issue mileage reimbursements and other benefits.
• Verify lost time and eligibility requirements.
• Monitor modified duty programs and diary closeouts.
• Maintain accurate claim notes and records.
• Escalate or convert to Indemnity status with supporting docs.
• Refer imaging requests for utilization review as required.
• Process medical bills promptly to ensure compliance.
• Review reserve levels and update financial exposure.
• Investigate questionable claims and escalate when needed.
• Maintain high-quality claim closure and service standards.
• Return calls and respond to inquiries within service standards.
• Review daily mail and electronic documents in a paperless environment.

Skills

Claim handling

Customer service

Attention to detail

Education

Bachelor's degree

Job description

Gallagher is hiring a Medical Only Claims Examiner in California. The role focuses on administering Medical Only workers' compensation claims with emphasis on accuracy, regulatory compliance, and excellent client service.

Remote work within California with opportunities for growth and impact. The candidate will handle timely processing, benefits administration, and documentation while collaborating with a team committed to integrity and client trust.