Medical Only Claims Adjuster

The Jonus Group•High Point, NC

5d•Remote

About The Position

Seeking a dedicated and detail-oriented Lost Time Workers' Compensation Claims Adjuster to join a growing team. This is a remote position, ideal for candidates located in the EST or CST time zones who are willing to work EST hours (7:00 AM - 9:00 AM EST start). As a key member of our claims team, you will manage a caseload of 90-120 files, with 5-10% involving litigation, across a variety of industries including transportation, schools, hospitality, and manufacturing. This role requires a strategic mindset, investigative expertise, and a commitment to delivering exceptional service.

Requirements

Minimum of 2 years of experience handling Workers' Compensation claims.
Proven ability to independently solve practical problems and prioritize tasks effectively.
Strong interpersonal skills with the ability to build and maintain professional relationships.
Experience adjusting claims in at least two of the following states: NC, SC, GA, TN (NC experience is highly preferred).
Fluent in English.

Nice To Haves

Adjuster’s license in one or more states is a plus.
Spanish language skills are a plus.
Demonstrated ability to employ strategic thinking and investigative techniques to manage claims.

Responsibilities

Conduct thorough investigations of new claims, including contacting employers and injured workers for recorded statements.
Determine coverage and assess the validity of claims.
Review medical bills to ensure proper payment and refer bills for audit when necessary.
File required forms with the Industrial Commission.
Establish appropriate reserves for claims.
Coordinate medical case management services and ensure injured employees receive necessary care.
Communicate effectively with insureds, injured workers, and attorneys.
Attend mediations and hearings as required.
Utilize proprietary claims software and ImageRight to manage claims efficiently.