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Claims Adjuster Jobs in Texas

Workers’ Compensation Medical Only Claims Adjuster | Remote

King'S Insurance Staffing

  • Dallas, Texas
  • 29 days ago
  • Remote
  • $50,000–$60,000 Per Year

Highlights

This is an excellent opportunity for a claims professional who enjoys investigating workplace injuries, working closely with medical providers, and managing claims from initial reporting through closure. This person will oversee and manage medical-only workers’ compensation claims, ensuring timely evaluations, appropriate medical care, and efficient claim resolutions.

Numbers & Facts

LocationDallas, Texas (
Remote
)
Salary$50,000–$60,000 Per Year

Description

Our client is seeking a Workers’ Compensation Medical Only Claims Adjuster to join their Texas team. This person will oversee and manage medical-only workers’ compensation claims, ensuring timely evaluations, appropriate medical care, and efficient claim resolutions.
This is an excellent opportunity for a claims professional who enjoys investigating workplace injuries, working closely with medical providers, and managing claims from initial reporting through closure. The ideal candidate will have a strong understanding of workers’ compensation regulations, medical billing practices, and claims administration.
Responsibilities
  • Handle a caseload of medical-only workers’ compensation claims involving exposures up to $10,000.

  • Investigate reported workplace injuries, gather supporting documentation, and evaluate claim eligibility.

  • Review claim details to make appropriate compensability decisions in accordance with applicable workers’ compensation regulations.

  • Oversee medical treatment activities, review provider invoices, and approve services within established authorization limits.

  • Maintain regular communication with injured employees, employers, healthcare professionals, and other involved parties.

  • Establish and update claim reserves based on medical expenses, claim developments, and anticipated exposure.

Qualifications
  • 1-3 years of workers' compensation medical only or claims associate experience.

  • Experience managing medical-only workers’ compensation claims preferred.

  • Active Texas adjusters license

  • Understanding of workers’ compensation laws, medical terminology, and applicable state regulations.

  • Familiarity with medical billing, treatment coordination, compensability determinations, and claim reserving.

  • Ability to evaluate medical records, investigate claims, and identify potential changes in claim exposure.

Salary & Benefits
  • $50,000 - $60,000 annually (depending on experience)

  • Competitive Medical, Dental and Vision plans

  • Employer match 401(k)

  • Paid Holidays & Paid Time off

  • Advancement opportunities internally within the organization

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