What are the responsibilities and job description for the Medical Only Claims Adjuster position at Questpro?
Location: Franklin, TN Area - Remote at first but it will be hybrid down the road.
Position Type: Temporary / Contract Opportunity (Potential Temp-to-Hire)
Our client is seeking an experienced Medical Only Claims Adjuster to join their team in the Nashville area. This position is ideal for a claims professional who enjoys managing a focused caseload and providing timely, accurate claim handling while delivering excellent service to injured workers and clients.
Job Responsibilities
Position Type: Temporary / Contract Opportunity (Potential Temp-to-Hire)
Our client is seeking an experienced Medical Only Claims Adjuster to join their team in the Nashville area. This position is ideal for a claims professional who enjoys managing a focused caseload and providing timely, accurate claim handling while delivering excellent service to injured workers and clients.
Job Responsibilities
- Manage an assigned caseload of Workers’ Compensation Medical Only claims from intake through resolution
- Review, investigate, and process medical-only claims in accordance with company guidelines and state regulations
- Evaluate medical documentation, bills, treatment plans, and supporting claim information
- Coordinate with medical providers, employers, injured employees, and other stakeholders
- Process and approve medical payments while ensuring accuracy and compliance
- Monitor claim activity, identify potential issues, and escalate as appropriate
- Maintain accurate claim files and documentation within the claims system
- Provide professional communication and customer service throughout the claim lifecycle
- 2 years of Workers’ Compensation claims handling experience
- Strong experience handling Medical Only claims required
- Knowledge of Workers’ Compensation regulations and claims processes
- Experience reviewing medical bills, treatment notes, and payment requests
- Strong attention to detail with excellent organizational skills
- Ability to manage multiple priorities and meet deadlines
- Excellent written and verbal communication skills
- Experience with claims management systems preferred
- Tennessee Workers’ Compensation Adjuster license or ability to obtain
- Prior experience with insurance carriers, TPAs, or self-insured programs
- Familiarity with medical terminology and workers’ compensation guidelines
- Monday – Friday, standard business hours
- Nashville, TN area (hybrid/onsite details to be provided)