Workers Compensation Claims Associate – Medical Only Claims

Jobtailor; Baltimore (MD); On-site; USD 42,000 - 62,000; Full time

Job summary

Jobtailor in Baltimore, MD is seeking an organized claims professional to become oriented in workers' compensation administration. You will analyze claims, determine benefits due, and support senior staff with larger cases.

The role requires strong communication, MS Office proficiency, ability to handle multiple priorities, and the capacity to work in an agile environment while maintaining documentation and client relationships.

Qualifications

• High school diploma or GED required.
• Strong oral and written communication.
• Computer literacy, including Microsoft Office.
• Organizational skills.
• Clerical or customer service experience or equivalent combination of education and experience preferred.
• Medical terminology preferred.
• Ability to work in an agile environment.
• Clear and conceptual thinking ability.
• Excellent judgment, troubleshooting, problem-solving, analysis, and discretion.
• Ability to handle work-related stress.
• Ability to handle multiple priorities simultaneously.
• Ability to meet deadlines.

Responsibilities

• Become oriented and trained as a new industry professional.
• Analyze workers compensation claims and determine benefits due.
• Adjust medical-only claims and minor lost-time workers compensation claims under close supervision.
• Support claims representatives, examiners, and leads with larger or more complex claims.
• Process workers compensation claims, determining compensability and benefits due.
• Monitor reserve accuracy and file necessary documentation with state agencies.
• Communicate claim actions and processing with claimants, clients, and appropriate medical contacts.
• Ensure claim files are properly documented and claims coding is correct.
• Process routine payments, prescriptions, and status reports for medical claims when required.
• Maintain professional client relationships.

Skills

Oral communication

Written communication

Organizational skills

Customer service

Medical terminology

Agile environment

Clear thinking

Analytical thinking

Judgment

Problem-solving

Stress management

Multitasking

Time management

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Job description

Responsibilities

• Become oriented and trained as a new industry professional
• Analyze workers compensation claims and determine benefits due
• Adjust medical-only claims and minor lost-time workers compensation claims under close supervision
• Support claims representatives, examiners, and leads with larger or more complex claims
• Process workers compensation claims, determining compensability and benefits due
• Monitor reserve accuracy and file necessary documentation with state agencies
• Communicate claim actions and processing with claimants, clients, and appropriate medical contacts
• Ensure claim files are properly documented and claims coding is correct
• Process routine payments, prescriptions, and status reports for medical claims when required
• Maintain professional client relationships

Requirements

• High school diploma or GED required
• Strong oral and written communication
• Computer literacy, including Microsoft Office
• Organizational skills
• Clerical or customer service experience or equivalent combination of education and experience preferred
• Medical terminology preferred
• Ability to work in an agile environment
• Clear and conceptual thinking ability
• Excellent judgment, troubleshooting, problem-solving, analysis, and discretion
• Ability to handle work-related stress
• Ability to handle multiple priorities simultaneously
• Ability to meet deadlines

Core Competencies

Demonstrates proficiency in analyzing and processing workers compensation claims, ensuring accurate documentation and communication with stakeholders. Exhibits strong organizational skills and the ability to manage multiple priorities in a fast-paced environment.

Highest-signal resume keywords

• Workers Compensation Claims Processing
• Medical Terminology
• Microsoft Office Proficiency
• Strong Oral And Written Communication
• Organizational Skills

Hard Skills

• Claims Analysis
• Claims Documentation
• Claims Coding
• Reserve Monitoring
• Payment Processing

Soft Skills

• Problem-Solving
• Clear Thinking
• Judgment
• Stress Management
• Multi-Priority Handling

Certifications & Qualifications

• High School Diploma
• GED

Industry Keywords

• Workers Compensation
• Claims Management
• Client Relationships
• Agile Environment
• Clerical Experience