Medical Only Adjuster

Davies International Ltd. • Lakewood Ranch, FL

39d • $44,000 - $52,000

About The Position

Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America , we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. Davies is seeking a detail-oriented and proactive Medical Only Adjuster to manage workers' compensation medical-only claims for assigned TPA clients. This role requires strong knowledge of Florida Workers' Compensation statutes, independent judgment, and the ability to deliver timely, compliant, and high-quality claims handling while maintaining exceptional service standards.

Requirements

• Working knowledge of Florida Workers' Compensation law, rules, procedures, and case law
• Understanding of liability principles, medical terminology, and treatment protocols
• Strong organizational skills with the ability to manage multiple priorities
• Excellent written and verbal communication skills
• Ability to independently manage a medical-only caseload while meeting performance metrics
• Strong attention to detail and commitment to compliance and quality

Responsibilities

• Investigate and adjust medical-only Workers' Compensation claims in compliance with Florida statutes and case law
• Complete timely 48-hour contacts with injured workers, employers, and medical providers
• Determine compensability, authorize medical treatment, and initiate required state and EDI filings
• Review, document, and approve medical bills within required timeframes
• Monitor medical care and coordinate return-to-work and light duty accommodations
• Establish and maintain appropriate reserves and diary/workflow compliance
• Maintain regular communication with injured workers and clients to ensure service quality
• Identify red flags, recovery opportunities, and escalate concerns as appropriate
• Meet performance standards, including claim closure and quality metrics
• Participate in required training, client meetings, and ongoing professional development

Benefits

• Medical, dental, and vision plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial future.
• Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• Paid holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed