Medical Only Claims Specialist

This is a Fully Remote Job About Our Client: The organization operates within the risk management sector, focusing on solutions for workers' compensation, auto, health, and disability management. Established in 1987 and publicly traded since 1991, the company addresses challenges in managing claims and risk by investing in human capital and technology to provide integrated services across the United States. With over 4,000 employees, the company emphasizes core values such as accountability, commitment, excellence, integrity, and teamwork. About the Opportunity: The MEDICAL ONLY CLAIMS SPECIALIST role involves managing non-complex workers’ compensation medical-only claims under close supervision. This position contributes by ensuring accurate claim validation, reserving, and communication to support the claims department's operational goals. The role is critical in maintaining efficient claims processing and compliance with client and carrier guidelines. Responsibilities: Receive workers’ compensation claims and confirm policy coverage Determine claim validity and compensability Establish reserves and authorize payments within limits Communicate claim status with customers, claimants, and clients Adhere to client and carrier guidelines and participate in claims reviews Assist with more complex claims as needed Perform additional assigned duties Requirements: Bachelor's degree or equivalent combination of education and experience Minimum of one year of industry experience in claims handling Workers’ compensation experience required Arizona Adjuster license required Proficiency with Microsoft Office, including Excel Strong customer service, communication, problem-solving, and organizational skills Ability to work independently and in a team environment Pay Range and Compensation Package: Pay range: $16.74 to $26.92 per hour Pay varies based on location, experience, qualifications, and other factors Benefits & Perks: Medical insurance (HDHP) with pharmacy Dental insurance Vision insurance Long term disability insurance Health savings and flexible spending account options Life, accident, and critical illness insurance Legal insurance Parking and transit flexible spending accounts 401(k) and Roth 401(k) Paid time off Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.