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Medical Claim Specialist Resume

2.00 Rating



Confidential, TX

Medical Claim Specialist


  • With supervision, you will evaluate claimant eligibility, communicate with attending physician and employer and injured worker
  • Work with both the claimant and their physician to medically manage the claim from initial medical requests to reviewing and evaluating on going medical information.
  • Work directly with employers to facilitate a return to work either on a Full - time or modified duty basis
  • Provide consistent customer service to both our customers and claimants through timely responses to all inquiries, telephone calls and emails while delivering on service commitments
  • Manage both new claims as well as open claims equally.
  • Demonstrate commitment to Company s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
  • Bachelor's degree or equivalent work experience is required
  • Knowledge of medical terminology and/or Workers Compensation a plus
  • The ability to multi-task and prioritize is needed; strong organization and time management skills are required
  • Demonstrated customer service skills are required
  • Strong verbal and written communication skills are required
  • Computer literate with good typing and computer skills (Microsoft Office) are required.

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