Remote WC Claims Adjuster I (Medical-Only)

AvonRisk; Austin (TX); Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401k with match

Paid time off

Paid holidays

Learning & development

Employee assistance program

Job summary

AvonRisk in Texas is seeking a Workers’ Compensation Claims Adjuster I to manage a medical-only WC caseload under close supervision. You will focus on timely investigation, medical bill review, utilization management, and driving claims to resolution.

You’ll work with experienced mentors and receive clear guidance from day one, gaining exposure to a diverse range of claim types and industries, making this a strong entry point for building essential WC skills.

Qualifications

• 1–3 years' experience as a WC claims assistant or trainee; or a bachelor's degree with WC exposure.
• Active Texas WC license required; multi-state license preferred.
• Bachelor’s degree or equivalent work experience with basic WC claims knowledge.

Responsibilities

• Conduct three-point contact with the injured worker, employer, and treating physician within required timeframes.
• Assess compensability, evaluate mechanism of injury, and determine benefits per state WC statutes.
• Maintain accurate claim documentation and classify claims as medical-only.
• Coordinate with utilization review and medical bill review teams; monitor progress toward MMI and return-to-work outcomes.
• Establish reserves and submit 90-day carrier status reports; manage settlements and subrogation where applicable.

Skills

Claims investigation

Case management

Reserving & reporting

Medical management

Regulatory knowledge

Microsoft Office

Education

Bachelor's degree

Texas WC license

AIC/ARM/SIP (bonus)

Tools

Guidewire

Juris

ClaimCenter

Job description

AvonRisk in Texas is seeking a Workers’ Compensation Claims Adjuster I to manage a medical-only WC caseload under close supervision. You will focus on timely investigation, medical bill review, utilization management, and driving claims to resolution.

You’ll work with experienced mentors and receive clear guidance from day one, gaining exposure to a diverse range of claim types and industries, making this a strong entry point for building essential WC skills.