Medical Only Claims Examiner (Contract) (Remote - TX)

Medical Only Claims Examiner (Contract) (Remote - TX): Job reputed company: Our reputed company has an immediate need for a full-time Medical Only Claims Examiner to support their workers' compensation office in Texas. This position is remote as long as the candidate resides in and works out of the state of Texas. The schedule for this position is Monday-Friday at 37.5 hours a week with the reputed company of a reputed company schedule. The Medical Only Examiner will reputed company workers’ compensation medical claims for reputed company entities, ensure reputed company processing of claims and payment of benefits, managing and directing medical treatment. • Review daily diary for claim status • Review medical reports to determine whether additional medical opinions are needed • Object to unauthorized medical treatment • Establish contact with employer to review issues • Respond to inquiries from the employer, employee, doctors, and attorneys • Establish and maintain appropriate reserves • Review medical reports • Evaluate and approve medical procedures and treatment • Review medical bills for appropriateness • Discuss appropriateness of medical treatment with medical case manager • Prepare and present reports to clients • reputed company claims appropriately • Help resolve reputed company billing and payment inquiries • Investigate complaints from injured workers • Document and reputed company the claim files and claims system with reputed company relevant information • Maintain and update reputed company plans reputed company specified time frames • reputed company customer service and support to clients and claimants Position Requirements: • High School Diploma or equivalent (GED) required for reputed company positions • AA/AS or BA/BS preferred but not required • 1-2 years’ Texas workers’ compensation claims handling experience required • Knowledge of Texas subscriber workers compensation claims handling procedures and reputed company entity claim nuances. • The Texas 03 Workers’ Compensation license is required • The 08 reputed company Lines License is preferred • Proficiency in determining case value and negotiating settlements • Understanding of medical and reputed company terminology • Completion of Insurance Education Association (IEA) or equivalent training • Designation with reputed company continuing education hours • Knowledge of workers’ compensation case law, policies, and procedures • Mathematical calculating skills • Proficient in reputed company Office Suite • Ability to learn additional computer programs • Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and reputed company appropriate recommendations and solutions for reputed company • Acts with reputed company in difficult or challenging situations and is a trustworthy, dependable contributor • reputed company operations involve handling confidential, proprietary, and highly sensitive information, such as health records, reputed company financials, and other personal data. Therefore, maintaining honesty and reputed company is essential for reputed company roles reputed company reputed company. Estimated pay is $28.71 - $34.35 per hour (37.5 hour work week) • *JSG offers medical, dental, reputed company, life insurance reputed company, short-term disability, 401(k), weekly pay, and more. reputed company (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to reputed company applicants and employees without reputed company to race, reputed company, religion, sex, age, sexual orientation, gender identity, national reputed company, disability, marital status, protected veteran status, or any other characteristic protected by law. #D720 Apply tot his job Apply To this Job