PA Workers' Compensation Medical Only Adjuster (Remote

Claim Representative, Medical Only - Pennsylvania Workers' Compensation

Location:
Remote

Schedule: Monday-Friday, 8:00am - 4:30pm EST

Salary Range: $45,000 - $55,000 annually, paid hourly (37.5 hours per week)

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.

We don’t just process claims—we support people. As the largest privately-owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work®, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.

Job Summary

The Medical Only Claim Representative is responsible for the handling and administration of Pennsylvania Workers' Compensation medical-only claims within a dedicated carrier program. This role manages a high-volume inventory of claims while ensuring timely, accurate, and compliant claim handling.

Working closely with claim staff and internal business partners, the Medical Only Claim Representative supports the claim process from initial assignment through closure by coordinating medical treatment, reviewing documentation, managing claim activity, and maintaining accurate claim records.

This position is ideal for individuals who have workers' compensation experience, strong organizational skills, and an interest in growing their claims career. It offers valuable exposure to claim handling while developing the technical knowledge needed for advancement into more complex adjusting roles.

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.

• Manage Pennsylvania Workers' Compensation medical-only claims from assignment through closure

• Review claim information and supporting documentation to ensure accurate claim setup and handling

• Coordinate and monitor medical treatment activities in accordance with claim handling standards

• Review and process medical bills, invoices, and claim-related documentation

• Maintain timely diary management and claim file documentation

• Summarize medical records, correspondence, and claim activities within the claim system

• Communicate with medical providers, employers, and internal claim partners as needed

• Monitor claim activity and identify opportunities for closure or escalation

• Assist claim staff with claim support activities and special projects

• Maintain compliance with Pennsylvania Workers' Compensation regulations, Corporate Claim Standards, and client-specific handling instructions

• Provide responsive service and support while maintaining quality and productivity expectations

Required:

• Associate degree or two years of related business, insurance, healthcare, claims, customer service, or administrative experience

• Knowledge of Pennsylvania Workers' Compensation claims or workers' compensation processes

• Strong attention to detail and organization skills

• Ability to manage a high-volume workload efficiently and accurately

• Strong written and verbal communication skills

• Ability to prioritize multiple tasks and deadlines

• Proficiency with Microsoft Office applications including:
  • Outlook
  • Word
  • Excel

• Ability to work independently in a remote environment

• Reliable attendance during established business hours

Nice to Have:

• Prior Pennsylvania Workers' Compensation experience

• Medical-only claim handling experience

• Carrier or TPA claim experience

• Knowledge of medical terminology

• Experience reviewing medical bills, treatment records, and claim documentation

• Experience working within a dedicated client or carrier program

• Interest in developing a long-term career in Workers' Compensation claims

• Bilingual (Spanish) proficiency — highly valued for communicating with claimants, employers, or vendors, but not required.

Why You’ll Love Working…