Technical Operator III

MedRisk

. Evaluate, negotiate, and settle workers’ compensation claims in compliance with applicable laws and internal policies .

Posted 10/13/2026full-timeRemote • California • United StatesJuniorMid-Level💰 $21 - $24 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in evaluating and negotiating workers' compensation claims while ensuring compliance with state regulations and internal policies. Proficient in analyzing medical billing codes and managing multiple cases effectively in a fast-paced environment.

Highest-signal resume keywords

Workers’ Compensation Claims HandlingMedical Billing Codes (CPT, ICD-10, HCPCS)Claims Management SystemsNegotiation SkillsAnalytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Workers’ Compensation RegulationsFee SchedulesCost-Saving OpportunitiesClaims DocumentationMedical Bill Review

Soft Skills

Excellent CommunicationAttention to DetailAbility to Manage Multiple Priorities

Tools & Technologies

Microsoft Office Suite

Industry Keywords

TPAInsurance CarrierMedical Cost Containment

About the role

Key responsibilities & impact

Evaluate, negotiate, and settle workers’ compensation claims in compliance with applicable laws and internal policies
Review and analyze medical bills, treatment records, and claim documentation to determine appropriate settlement values
Negotiate with medical providers and other parties to reach fair and timely resolutions
Ensure compliance with applicable state workers’ compensation laws and regulations
Maintain accurate and up-to-date documentation of negotiations and outcomes in the claims management system
Identify cost-saving opportunities and minimize claim exposure
Communicate clearly and professionally with internal and external contacts
Monitor claims for trends and report potential areas of concern
Work closely with providers, adjusters, and internal teams

Requirements

What you’ll need

2–5 years of experience in workers’ compensation claims handling, bill review, or negotiation (or equivalent combination of education and experience)
Strong knowledge of workers’ compensation regulations and fee schedules
Strong understanding of medical billing codes (CPT, ICD-10, HCPCS), state fee schedules, and PPO discounts
Excellent written and verbal communication and negotiation skills
Strong attention to detail and ability to manage multiple cases independently
Excellent analytical skills
Ability to work independently and manage multiple priorities in a fast-paced environment
Proficiency with claims management systems and Microsoft Office Suite
Experience in a TPA, insurance carrier, or medical cost containment company preferred