Medical Only Claims Adjuster

Department: Unison Risk Solutions

Location: Hybrid (PA, MD, DC, VA) or Remote

FLSA Status: Non-Exempt

Grow With Us

At RCM&D, our employees are also owners, invested in our work, our clients, and our communities. We’re looking for a Medical Only Claim Adjuster who values collaboration, takes pride in their contributions, and wants to grow with a firm where shared success truly matters.

Our Just Cause

Together, we’re creating a future where success is shared and communities thrive.

• Our solutions and expertise empower our clients to realize opportunities, generate wealth and improve wellbeing.
• Our shared ownership model aims to create prosperity for all colleagues that share our values and embrace our cause.
• Our generosity with both our time and money moves our communities forward.
  
  

Who We Are

RCM&D, a Unison Risk Advisors company and 2025 Awarded Best Places to Work is ranked among the top independent insurance advisory firms in the United States. Founded in 1885, we leverage our 140 years of experience and strong local, national and global reach to meet clients’ business objectives.

We are relationship-driven, growth-minded, and deeply committed to doing the right thing for our clients, colleagues, and communities.

The Role

Investigate and manage all aspects of Medical Only Workers’ Compensation claims in Maryland and surrounding jurisdictions in accordance with jurisdictional requirements to the best possible resolution .

What You’ll Do

• Review, examine, investigate, and analyze medical only workers’ compensation claims.
• Interact with employers to confirm and discuss claim details.
• Investigate compensability issues, including taking recorded statements and reviewing medical records.
• Determine compensability
• Coordinate medical treatment for injured employees and provide information to treating physicians regarding employee’s medical history, health issues, and job requirements.
• Serve as a liaison between medical providers, employees, and employer departments; and inform departments of an injured employee’s work restrictions and coordinate appropriate accommodations.
• Review and interpret doctor’s reports to ensure that the appropriate American Medical Association (AMA) guidelines have been applied.
• Monitor medical treatment on assigned claims
• Approve medical payments timely on assigned claims
• Monitor and finalize subrogation recovery on assigned claims when applicable.
• Provide pro-active claim management, including following up with doctors’ offices and claimants for treatment and work status.
• Enter timely and detailed file notes
• Maintain a diary for file updates
• Accurately manage claim data
• Issue denial letters to providers and claimants when appropriate
• Make recommendations regarding claim handling and resolution
• Develop and maintain professional relationships with assigned clients through timely communication/responses to client
• Adhere to URS standards and procedures
• Document claim activity in the claim processing system
• Additional duties as assigned
  
  

What You Bring

Required Qualifications

• High school diploma or GED, plus a minimum of 1-2 years of performing the duties of this position or one with similar requirements. Some college preferred .
• Maintain a client centric focus; is highly responsive to internal and clients’ needs and can manage/meet/exceed expectations.
• Team player with a positive attitude and willingness to learn; work collaboratively with internal and external stakeholders.
• Ability to work independently with limited supervision.
• Ability to learn third party computer programs/websites.
• Possess the following skills:
• Strong oral and written communication
• Proactivity
• Critical thinking
• Organization and time management
• Accounting and analytical
• Strong attention to detail
• Demonstrate accountability, work well under pressure, and meet deadlines and deliverables.
• Projects confidence in interactions with colleagues and clients.
• Contribute to team efficiency by sharing knowledge and best practices.
• Proficient with Microsoft Office suite, and experience with claim management software is a plus.
  

How You Show Up (Our Core Values In Action)

Successful team members at RCM&D are:

• Reliable & Dependable – We build trust through reliability and consistency in everything we do
• Inspiring, Passionate & Positive – We are passionate about our work and inspire others through out dedication, positive attitudes and enthusiasm
• Driven by Integrity & Trust – We do what’s right, even when it’s hard or when no one is watching
• Selfless Team Players – We succeed together as a team by putting the needs of our clients and colleagues above our own
• Entrepreneurial & Solutions-Oriented – We challenge the status quo and don’t accept “no” as final
  
  

What We Offer

• Comprehensive benefits package
• Employee ownership through a 401(k) employer match and discretionary profit-sharing contributions
• Professional development and career growth opportunities
• Flexible work arrangements (remote and hybrid options) with a flexible paid time off approach
  
  

Equal Opportunity Employer

RCM&D, a Unison Risk Advisors company and founding member of Assurex Global, is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.