PA Workers' Medical Adjuster; Remote

Medical Only Claim Representative, Pennsylvania Workers' Compensation

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.

• 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

• 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

• 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.

• 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 opportunities

Culture: A supportive, team-based work environment

At CCMSI, we believe in doing what's right—for our clients, our coworkers, and ourselves. We look for team members who:

• Lead with transparency We build trust by being open and listening intently in every interaction.
• Perform with integrity We choose the right path, even when it is hard.
• Chase excellence We set the bar high and measure our success. What gets measured gets done.
• Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
• Win together Our greatest victories come when our clients succeed.

We don't just work together—we grow together. If that sounds like your kind of workplace, we'd love to meet you.