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Medical Only Claims Representative
Berkshire Hathaway GUARD Insurance Companies. Manage Workers' Compensation medical-only claims from initial report through resolution .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing Workers' Compensation claims, including determining compensability, coordinating medical treatment, and ensuring compliance with regulations. Proficient in communication and customer service, facilitating effective interactions between injured workers, employers, and medical providers.
Highest-signal resume keywords
Workers' Compensation Claims ManagementMedical Terminology ApplicationAdjuster LicenseMicrosoft Office ProficiencyCustomer Service Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
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Hard Skills
Claims ProcessingMedical Bill ReviewCompensability DeterminationDocumentation MaintenanceRegulatory Compliance
Soft Skills
Strong CommunicationOrganizational SkillsAttention to Detail
Tools & Technologies
Business Technologies
Certifications & Qualifications
Active Adjuster License
Industry Keywords
Workers' CompensationReturn-to-Work CoordinationClaim Management
About the role
Key responsibilities & impact- Manage Workers' Compensation medical-only claims from initial report through resolution
- Determine compensability and ensure timely delivery of benefits
- Coordinate medical treatment and facilitate early return-to-work efforts
- Review and process medical bills for payment
- Serve as a liaison between injured workers, employers, and medical providers
- Provide guidance regarding Workers' Compensation processes and claim management
- Maintain accurate claim documentation and comply with applicable regulations and company procedures
- Provide timely service to injured workers, employers, and medical providers
- Communicate, coordinate, and administer Workers' Compensation claims
Requirements
What you’ll need- Proficiency with Microsoft Office applications and other business technologies
- Strong communication, organizational, and customer service skills
- Ability to understand and apply medical and legal terminology related to Workers' Compensation claims
- Strong attention to detail
- Ability to learn new technology and systems
- High School Diploma/GED required
- Active adjuster license, or willingness and ability to obtain and maintain all required state licenses
- Independent participation in interviews; unauthorized recording, transcription, AI note-taking, or AI interview assistance tools may not be used without prior approval
Benefits
Comp & perks- Hybrid schedule: 2 days remote / 3 days in-office
- Predictable hours (no nights, weekends, or holidays)
- Competitive pay
- Generous PTO
- Medical, dental & vision starting day one
- 401(k)
- Tuition reimbursement
- Longevity bonuses
- Company support for licensing process, including cost, training and compliance with ongoing continuing education requirements