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Claims Adjuster Jobs in Texas

Workers’ Compensation Medical Only Claims Adjuster | Remote

King'S Insurance Staffing

  • Dallas, Texas
  • 24 days ago
  • Remote

    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
    )
    Websitehttps://www.thekingstaffing.com

    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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