Remote Medical Workers' Comp Claims Specialist

PMA Companies; Roseville (CA); On-site; USD 58,000 - 73,000; Full time

Job summary

PMA Companies in the United States is seeking an Associate Claims Specialist (Medical-Only – Workers Compensation) to proactively manage medical-only and limited lost time claims and to deliver strong customer service.

Responsibilities include securing missing information on First Notices of Loss, processing payments, approving treatments, timely contacts within 24 hours, and ensuring compliance with jurisdictional requirements. Remote position with CA locations optional.

Qualifications

• High school diploma or equivalent.
• 1+ years of Workers' Compensation claims handling.
• License required or ability to obtain within 90 days.
• Familiarity with medical terminology.
• Ability to work independently, handle multiple tasks, and focus on details.
• Strong organizational and communication skills.
• Proficiency with MS Excel and MS Word.
• Remote position.

Responsibilities

• Contact accounts on First Notices of Loss to obtain missing information.
• Process payments, answer calls, authorize medical treatment for Medical Only claims.
• Complete contacts within 24 hours and maintain a diary for follow-up.
• Determine treatment appropriateness and relation to the injury.
• Redirect treatment to network physicians as appropriate.
• Refer subrogation or permanency claims to Supervisor.
• Ensure compliance with jurisdictional requirements on Medical Only claims.
• Maintain knowledge of state adjusting licenses.
• Administer benefits on Permanent Total or Death cases and monitor changes.
• Adhere to the Company's Code of Business Conduct and Ethics.

Skills

Verbal and written communication

Independent work

Organizational skills

Education

High school diploma or equivalent

Tools

MS Excel

MS Word

Job description

PMA Companies in the United States is seeking an Associate Claims Specialist (Medical-Only – Workers Compensation) to proactively manage medical-only and limited lost time claims and to deliver strong customer service.

Responsibilities include securing missing information on First Notices of Loss, processing payments, approving treatments, timely contacts within 24 hours, and ensuring compliance with jurisdictional requirements. Remote position with CA locations optional.