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CCMSI
Claim Representative, Medical Only
Career Insights for Medical Claims Processor / Representative
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Based on Florida data
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$41,153 / year median in Florida
-3% projected decline
Job Description
Claim Representative, Medical Only CCMSI
- 3.2 Maitland, FL Job Details Full-time $23
- $25 an hour 14 hours ago Benefits Paid holidays Disability insurance Health insurance Dental insurance 401(k) Paid time off Vision insurance Employee stock ownership plan Opportunities for advancement Qualifications Microsoft Excel Microsoft Outlook Serving clients Phone communication Client interaction via phone calls
Full Job Description Overview:
Position Title :
Workers' Compensation Claim Adjuster, Medical Only Location :
Hybrid- Maitland, FL (Greater Orlando Area)
Hours :
Monday- Friday, 8:00 AM to 4:30
PM ET Salary Range :
$23/hr- $25/hr Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.
Responsibilities:
When we hire claim reps at CCMSI, we look for detail oriented professionals who understand that every task supports a real person's claim experience, value accuracy and responsiveness, and contribute to the team's success through organization, collaboration, and a strong commitment to service. 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 instructionsQualifications:
Required:
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 toHave:
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. Why You'll Love Working Here 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunitiesCulture:
A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact.We measure success by:
Quality claim handling- thorough investigations, strong documentation, well-supported decisions Compliance & audit performance
- adherence to jurisdictional and client standards Timeliness & accuracy
- purposeful file movement and dependable execution Client partnership
- proactive communication and strong follow-through Professional judgment
- owning outcomes and solving problems with integrity Cultural alignment
- believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us.