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Medical Only Adjuster Jobs (NOW HIRING)

CCMSI

Claim Representative, Medical Only

Metairie, LA · On-site

$20.51/hr

Overview Claim Representative, Medical Only Location : Metairie, LA (Onsite) Schedule: Monday ... Active Louisiana Adjuster License or the ability to obtain within first 60 days of employment ...

CCMSI

Claim Representative, Medical Only

Metairie, LA · On-site

$20.51/hr

... level adjuster positions. The role requires strong organization, attention to detail, and the ... medical-only claim files in accordance with corporate claim standards and applicable laws • ...

CCMSI

Claim Representative, Medical Only

Metairie, LA

$20.51/hr

Claim Representative, Medical Only Location : Metairie, LA (Onsite) Schedule: Monday-Friday, 8:00 ... level adjuster positions. The role requires strong organization, attention to detail, and the ...

Athens Administrators

Assistant Claims Examiner

Orange, CA · On-site +1

$28.32 - $31.49/hr

Medical Only Adjuster designation required * Continuing hours must be current * Mathematical calculating skills * Completion of IEA or equivalent courses * Administrators Certificate from Self ...

CCMSI

Claim Representative, Medical Only

Birmingham, AL · On-site

Claim Representative, Medical Only Location : Birmingham, AL (Hybrid) Schedule: Monday-Friday, 7:30 ... A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand ...

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$75.2K

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How much do medical only adjuster jobs pay per year?

As of Jun 11, 2026, the average yearly pay for medical only adjuster in the United States is $75,193.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,000.00 and $84,000.00 per year, depending on experience, location, and employer.

What's the maximum income to qualify for Medi-Cal?

For a Medical Only Adjuster, eligibility for Medi-Cal depends on income levels, which are generally set as a percentage of the Federal Poverty Level (FPL). In California, for example, the income limit for Medi-Cal eligibility is typically 138% of the FPL for adults, but it varies based on household size and specific program rules. It's important to check current state guidelines or use the online eligibility calculator for precise qualification thresholds.

What are some common challenges faced by Medical Only Adjusters when managing multiple claims simultaneously?

Medical Only Adjusters often handle a high volume of claims at once, which can make time management and organization critical challenges. Accurately tracking medical documentation, timely communication with healthcare providers, and ensuring prompt claim resolution require strong multitasking skills. Staying current on workers' compensation laws and maintaining detailed notes are essential for avoiding errors. Collaboration with other adjusters, nurses, and legal teams is also common, especially when claims escalate or require additional review.

What are the key skills and qualifications needed to thrive as a Medical Only Adjuster, and why are they important?

To thrive as a Medical Only Adjuster, you need knowledge of workers’ compensation laws, claims processing, and medical terminology, often supported by relevant experience or insurance certification. Familiarity with claims management software and document management systems is typically required. Strong attention to detail, organizational skills, and effective communication are important soft skills for efficiently handling claims and collaborating with providers. These competencies are crucial to ensure accurate claims resolution, compliance with regulations, and positive claimant experiences.

Is Medi-Cal the same as Medicaid?

Medi-Cal is California's Medicaid program, and Medicaid is a joint federal and state program providing health coverage for low-income individuals nationwide. While they share similar benefits and eligibility criteria, Medi-Cal is specific to California, whereas Medicaid varies by state in terms of coverage and rules. Medical Only Adjusters working in claims processing should understand these programs' differences for accurate claim handling.

What is the difference between Medical Only Adjuster vs Property Claims Adjuster?

AspectMedical Only AdjusterProperty Claims Adjuster
CertificationsTypically requires adjuster license, possibly medical certificationsRequires adjuster license, sometimes specific to property claims
Work EnvironmentPrimarily office-based, field visits to medical providersOffice and field work inspecting property damage
Industry UsageUsed mainly in insurance companies handling health-related claimsUsed in property and casualty insurance claims
Search/Comparison IntentOften compared for claims handling scope and credentialsRelated but focuses on physical property damage

The Medical Only Adjuster specializes in claims related to medical benefits and injuries, often requiring medical knowledge and specific licenses. In contrast, a Property Claims Adjuster handles physical damage to property, such as homes or vehicles. While both roles involve claims investigation and settlement, their focus areas, required credentials, and work environments differ significantly.

Does medical aid cover hair transplants?

A Medical Only Adjuster typically reviews insurance claims and coverage policies; whether medical aid covers hair transplants depends on the specific insurance plan and its coverage for cosmetic procedures. Most medical aid plans consider hair transplants as elective or cosmetic, and they are often not covered unless medically necessary due to injury or medical condition. It is advisable to review the policy details or consult with the insurance provider for precise coverage information.

What is a Medical Only Adjuster?

A Medical Only Adjuster is an insurance professional who handles workers' compensation claims that involve only medical expenses and do not include lost wage benefits. Their primary responsibility is to review, process, and manage claims where the injured employee requires medical treatment but can still work or does not miss significant time from work. They communicate with medical providers, claimants, and employers to ensure proper documentation and payment of medical bills. This role is crucial to ensure that claims are handled efficiently and within the guidelines set by state laws and insurance policies.

What does medical mean?

In the context of a Medical Only Adjuster, the term 'medical' refers to claims related solely to medical injuries or conditions without involving property damage or other damages. The role involves reviewing medical reports, determining coverage, and managing medical benefit claims, often requiring knowledge of medical terminology and insurance policies.
More about Medical Only Adjuster jobs
What cities are hiring for Medical Only Adjuster jobs? Cities with the most Medical Only Adjuster job openings:
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What job categories do people searching Medical Only Adjuster jobs look for? The top searched job categories for Medical Only Adjuster jobs are:
Medical Only Adjuster jobs near you
Infographic showing various Medical Only Adjuster job openings in the United States as of June 2026, with employment types broken down into 2% As Needed, 89% Full Time, and 9% Contract. Highlights an 63% Physical, 12% Hybrid, and 25% Remote job distribution, with an average salary of $75,193 per year, or $36.2 per hour.
Medical Only Adjuster

Medical Only Adjuster

Claims Administrative Services, Inc.

Tyler, TX • Remote

Full-time

Posted 7 days ago

Job description

About Us

Claims Administrative Services, Inc (CAS) has served as a third-party administrator handling workers' compensation and property and casualty claims for a wide array of clients since 1990. In addition to our claims experience, CAS offers safety and loss control, cost containment services, and program administration. Every day our experienced professionals are on the job, reducing the frequency and severity of workplace injuries, managing associated claims costs, and helping injured employees return to work. Our personalized customer service combined with dedicated experience, innovation, and cost efficiency, assists our clients in reducing costs and protecting their employees.

Structure and Ownership

Heartland Security Insurance Group is the holding company for Claims Administrative Services, Inc. Heartland is comprised of seven different insurance and risk management businesses, providing products and services globally. Each of the companies offer solutions to distinct client groups in the federal, state and private sectors. The organization has been under continuous private family ownership for 50 years. Today, it has over 60 stockholders as well as ESOP ownership. In addition to providing an important retirement benefit to associates, the Employee Stock Ownership Plan (ESOP) assures that everyone in the organization has a vested interest in providing the very highest level of service to the client.

Commitment to the Community

Claims Administrative Services, Inc., and the parent organization, Heartland Security Insurance Group, have a long history of philanthropy to the local, national, and international communities.

Medical Only Adjuster

Primary Responsibility

The Medical Only Adjuster will manage an assigned caseload of medical only Workers’ Compensation claims from the first report of injury to resolution according to the applicable law. The Medical Only Adjuster is mentored and trained by a licensed adjuster and will interact with claimants, policyholders, and other third parties throughout the claims management process.

Essential Functions & Responsibilities

Participate in training and introduction to workers’ compensation claims.

Learn to read and interpret complex documents including regulations, statues, legal documents, investigative reports, medical records, medical bills, and claims notes.

Learn to use claims management software and other related software for claims handling and reporting.

Learn to make timely initial contacts and investigation of new claims.

Learn to determine compensability.

Learn to set reserves appropriately.

Learn to document files daily on every conversation and action taken.

Learn to request Peer Reviews as needed.

Learn to request jurisdictional forms timely and accurately.

Train in monitoring ongoing medical treatment.

Learn to work mail and diary on a daily basis.

Communicate with clients and medical providers.

Additional Functions & Responsibilities

Prepares reports and other analytical data as requested by the management team.

Assist others in the department with various duties or projects.

Required Qualifications

High school diploma.

At least one year experience in an office environment with an emphasis on customer service.

Meet the standards and requirements set forth by the state to secure an adjuster license within the designated time frame.

Preferred Qualifications

College degree in business or other related discipline.

Previous experience in insurance or medical office environment.

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