Claim Representative, Medical Only

Ccmsi • Birmingham, AL

17h • Hybrid

About The Position

The Medical Only Claim Representative is responsible for managing designated medical‑only workers’ compensation claims for a single trucking account within the Alabama jurisdiction. This role handles a low‑complexity caseload of claims and focuses on timely medical coordination, accurate documentation, and responsive customer service. The position provides critical support to claim staff and client service teams and may serve as a training role for future advancement into higher‑level claim positions.

Requirements

• Associate Degree or two (2) years of related business experience
• Customer‑service oriented mindset with comfort communicating by phone
• Strong organizational skills and ability to multitask effectively
• Ability to work efficiently on a computer and manage detailed documentation
• Proficiency with Microsoft Office applications including Word, Excel, and Outlook
• Reliable, predictable attendance during assigned business hours

Nice To Haves

• Knowledge of medical terminology
• Prior experience in claims, insurance, or medical administrative support
• Experience supporting a single client or program environment
• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.

Responsibilities

• Set up and manage medical‑only claim files in accordance with corporate claim standards and applicable laws
• Establish reserves and provide reserve recommendations within authorized levels under direct supervision
• Review and approve medical and miscellaneous invoices on designated claims; negotiate disputed bills or invoices under supervision
• Request and monitor medical treatment in accordance with corporate claim handling standards
• Summarize correspondence and medical records in claim system notes and file documentation appropriately
• Close claim files when appropriate and retrieve closed files for re‑filing as requested
• Provide ongoing support to claim staff on client service teams
• Communicate with medical providers, injured workers, and internal partners; frequent phone work is required
• Ensure compliance with corporate claim handling standards and special client handling instructions

Benefits

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
• Medical, Dental, Vision, Life, and Disability Insurance
• 401(k) and Employee Stock Ownership Plan (ESOP)
• Internal training and advancement opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree