Skip to main content
Tallo logoTallo logo

Find Jobs

Find Jobs Near You – Available Work in Your Location

Skip to job details
Apply for this opportunity

To apply for this job, you'll continue to an external website or email application.

PMA Companies

Associate Claims Specialist - Medical-Only - Workers Compensation

Career Insights for Compensation / Benefits Specialist

See where this job fits in the broader career landscape. Knowing your career path helps you see what's possible from here.

Scorecard

Based on California data

Review key factors to help you decide if this role fits your goals. How is this calculated?

Were these scores useful?

What they do

A Compensation or Benefits Specialist evaluates and works to maintain the pay structure and benefits program at an organization. Analyzes wage and salary data and trends, monitors market conditions; works with benefits vendors, processes benefit claims for employees; monitors government employment regulations. May focus specifically on job classifications and compensation or on benefits programs such as pensions.

$75,366 / year median in California

-15% projected decline

Explore Career

Job Description

As a member of our Claims team, you will proactively manage medical only and limited lost time claims in order to minimize losses, manage permanent total claims in order to minimize losses, and provide superior customer service.

Responsibilities:

Contact accounts on First Notices of Loss to obtain missing information pertinent to file set-up

Process payments, answer phone calls, authorize treatment associated with Medical Only claims

Complete appropriate contacts within 24 hours of assignment, and establish and maintain appropriate diary for follow-up

Determine whether treatment is appropriate and causally related to the compensable injury

Redirect treatment to network physicians as appropriate

Refer subrogation potential claims or potential permanency claims to Supervisor

Work to ensure compliance with all appropriate jurisdictional requirements on Medical Only claims, including timely form filing if applicable

Maintain a working knowledge of jurisdictional requirements and obtain/maintain state adjusting licenses

Administer benefits on Permanent Total or Death cases, which includes monitoring for changes in life or work status, implied interest in resolution or marked increases in costs.

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. High school diploma or equivalent

One or more years of Workers Compensation claims handling experience

License required or ability to obtain license within 90 days of employment in mandated states

Familiarity with medical terminology

Ability to work independently, handle multiple tasks simultaneously, make difficult decisions and focus on details

Strong organizational skills

Excellent verbal and written communication skills

Proficiency MS Excel and MS Word.