Workers Comp Medical Only Claims Specialist

Largo, Maryland
Not Specified
Mar 22, 2019
May 21, 2019
Job Type
Full Time
Career Level
Not Specified

General Description:

Manage within company best practices lower-level non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional.

Essential Job Duties:

  1. Receives claim, confirms policy coverage and acknowledgement of the claim
  2. Determine validity and compensability of the claim
  3. Establish reserves and authorize payments within reserving authority limits
  4. Manage non-complex and non-problematic medical-only claims and minor lost-time workers' compensation claims under close supervision
  5. Communicate claim status with the customer and claimant and client
  6. Adhere to client and carrier guidelines and participate in claims review as needed
  7. Assists other claims professionals with more complex or problematic claims as necessary
  8. Requires regular and consistent attendance.
  9. Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
  10. Additional duties as required.

Education/Training Requirements:


  1. Excellent written and verbal communication skills
  2. PC literate, including Microsoft Office (Word, Excel)
  3. Ability to learn rapidly to develop knowledge and understanding of claims practice
  4. Ability to identify, analyze and solve problems
  5. Strong organizational skills
  6. Good interpersonal skills
  7. Ability to work independently
  8. Ability to work in a team environment
  9. Ability to meet or exceed performance competencies


  • College degree preferred, work experience can substitute for educational requirement


  • One (1) year of industry experience and claims management preferred

#cb *mon*

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