Job Description
Worker Compensation Claims Adjuster
Job Summary:
We are looking for a motivated entry-level Claims Adjuster to join our team handling workers’ compensation claims in Pennsylvania. This role focuses on investigating, managing, and resolving medical-only and minor lost-time claims under close supervision while learning Pennsylvania workers’ compensation laws and best practices.
Responsibilities:
● Receive and Review New Claims : Gather initial reports from employers, employees, and witnesses about work-related injuries or illnesses.
● Investigate Claims : Contact claimants, employers, and medical providers; review medical records, accident reports, and other documents to verify if the injury is work-related and covered.
● Determine Compensability : Decide whether to accept or deny the claim based on Pennsylvania workers’ comp laws (e.g., was it in the course of employment?). Entry-level roles often handle straightforward cases with limited authority.
● Manage Benefits : For approved claims, process medical bills, approve treatments, coordinate care, and calculate/ issue wage-loss payments.
● Set Reserves : Estimate and set aside money for the expected cost of the claim.
● Proper Claim File Documentation : Maintain detailed claim files, notes, and status reports in compliance with state rules and company policies.
● Identify Issues : Spot potential fraud, subrogation (recovering costs from third parties), or complex matters and escalate them to a supervisor.
● Close Files : Finalize and close simple claims when the worker recovers and returns to
Required Skills & Qualifications:
● High school diploma. (College/University diploma preferred).
● Strong communication (oral and written), organization, and analytical skills.
● Basic computer proficiency (Microsoft Office, claims software).
● Ability to interpret medical info and apply laws/regulations (will be trained in how to do so).
Preferred Qualifications:
● Prior experience handling Pennsylvania workers’ compensation claims preferred.
● Familiarity with claims systems or regulatory reporting tools (EDI (WCAIS), CMS, PCRB)
● Licensure (as a producer, or any claims’ designation) Not Required
Company DescriptionFamily-owned, highly communicative, and collaborative culture. Opportunities for advancement and paid training for certification.
Family-owned, highly communicative, and collaborative culture. Opportunities for advancement and paid training for certification.
A leading audio content company is seeking an On-Air Personality for its Wichita, Kansas station. In this part-time role, you will perform live broadcasts, engage with audiences, and maintain strong local sports industry contacts. Candidates should have on-air experience...
...facility. This role plays a critical part in driving aggressive recruiting efforts for both hourly production roles and salaried... ...or are limited in the ability or unable to access or use this online application process and need an alternative method for applying...
Are you interested in house sitting in Chandler, Arizona? I'm looking for a responsible individual to take care of my home while I'm away. The job involves pet feeding, mail collection, plant care, and managing trash and recycling. Your primary responsibility would be to...
...Bonus | 26/27 School Year | $45-$50/hour | Full-Time | North Chicago, IL | LBS1 PEL Required About the Role: Lead a special education classroom serving students with diverse learning needs. You'll develop and implement IEPs, manage classroom behavior using PBIS...
...Overview A New Leaf School of Nashville is a vibrant, child-centered learning community dedicated to nature-based and project-based education. Our approach integrates hands-on, experiential learning with an emphasis on environmental stewardship, creativity, and critical...