Workers’ Compensation Medical Only Claims Adjuster | Dallas, TX area

Insurance Placement Solutions (IPS) has an immediate opening for a Workers Compensation Medical Only Claims Adjuster with our client in Irving, Texas. This is a direct-hire opportunity focused on medical-only workers’ compensation claims. In-office candidates are preferred, although hybrid arrangements may be considered, particularly for candidates residing outside the Dallas metroplex.

In this role, you’ll manage medical-only workers’ compensation claims from investigation through resolution, with claim exposure up to $10,000. You’ll determine compensability, coordinate medical treatment, review medical billing, establish reserves, and identify claims requiring additional review or escalation.

Workers’ Compensation Medical Only Claims Adjuster Responsibilities

• Manage medical-only workers’ compensation claims with exposure up to $10,000
• Investigate claims and determine compensability in accordance with applicable state requirements
• Coordinate and monitor medical treatment and associated medical billing
• Authorize medical treatment and claim payments within designated authority
• Establish and maintain appropriate claim reserves
• Monitor claims for potential lost time, indemnity exposure, litigation, or increased complexity
• Escalate claims exceeding $10,000 in exposure or requiring indemnity handling to the Claims Supervisor
• Maintain accurate claim documentation and an effective diary system
• Communicate claim developments with claimants, employers, medical providers, vendors, and clients
• Identify and report injury trends or safety concerns to clients
• Participate in claim file reviews as needed
• Ensure claims are handled in accordance with applicable workers’ compensation regulations and client requirements

Qualifications

• 1–3 years of workers’ compensation claims handling experience
• Experience handling medical-only workers’ compensation claims
• Experience with subscriber workers’ compensation claims
• Working knowledge of workers’ compensation regulations and medical terminology

Preferred

• Experience handling workers’ compensation claims for cities, counties, municipalities, or other public entities
• Bachelor’s degree in a related field
• Proficiency with Microsoft Word and Excel

Work Arrangement

• Direct-hire opportunity
• Position based in Irving, Texas
• In-office work preferred
• Hybrid arrangements may be considered, particularly for candidates outside the Dallas metroplex

About Insurance Placement Solutions

Insurance Placement Solutions is a staffing and recruiting firm specializing in the insurance industry. We connect talented professionals with temporary, temp-to-hire, and direct-hire opportunities at leading insurance organizations across the United States.

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