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Medical Only Adjuster Jobs (NOW HIRING)

CCMSI

Claim Representative, Medical Only

Danville, IL · On-site

$20.50 - $22/hr

Overview Claim Representative, Medical Only Location : Danville, IL Schedule: In Office for ... A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand ...

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Medical Only Adjuster information

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$37K

$75.2K

$127.5K

How much do medical only adjuster jobs pay per year?

As of Jul 4, 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 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.

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.

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.
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Medical Only Adjuster jobs near you
Workers' Compensation Medical Only Adjuster

Workers' Compensation Medical Only Adjuster

Integrion Group Inc

Albuquerque, NM • On-site

$64K - $82K/yr

Full-time

Posted 19 days ago

Job description

Job Type
Full-time
Description
Job Title: Workers' Compensation Medical Only Adjuster
Department: Workers' Compensation
Reports to: Workers' Compensation Claims Manager
Position Summary:
This position is responsible for the adjudication of medical only workers' compensation claims, assigned by our clientele, in accordance with the New Mexico Workers' Compensation Statute, governing rules and regulations, related case law and client and company procedures. New loss assignments are client specific, based on case complexity.
Essential Functions:
  • Investigate the claim and verify information to determine cause of injury/accident history; determination of compensability. Interviewing employer, employees, witnesses; coordination of medical treatment and will learn skills necessary to take a recorded statement.
  • Must possess the ability to maintain accurate and complete claim documentation in CMS and or other client proprietary claim systems utilized. This position is responsible for reporting to clients per their specific guidelines. Must show proficiency in utilizing a diary system and keep open files maintained on that diary.
  • Has to have strong analytical skills for proper posting and monitoring of reserves for medical exposure pursuant to client instructions and or company best practice standards.
  • Timely review and payment of medical bills per NM Statutory requirements. Must be familiar with related case law and the ability to interpret and comply with client and company standards, policies and procedures.
  • Must make required State filings through EDI. Ensure that proper outside vendors referrals are made and properly justified. Knowledge of medical terminology to evaluate and interpret medical records / reports ensuring treatment is related to the reported injury. Identify strategies to close claim files timely or to transfer claims to a lost time adjuster for management of indemnity and more complex medical issues.
  • This position is also be an introduction to future disability payouts; finite periods of disability indemnity benefits and long term medical maintenance supervision.
  • Attend seminars, education opportunities and industry functions as a representative of the company.

Requirements
Job Qualifications:
Education:
High school diploma required. Bachelor's degree from an accredited college or university preferred.
Experience:
This is an entry-level training position, however it is preferred that the applicant have some knowledge and recognition of a workers' compensation claim. Prefer one to three years in the insurance industry or similar experience handling claims. Additional relevant experience considered in lieu of education.
Required Skills/Abilities:
  • Demonstrate expertise evaluating and workers' compensation medical claims required.
  • Demonstrate beginning to intermediate knowledge of medical issues and injury occurrences.
  • Possess superior customer service and conflict resolution skills.
  • Strong presentation and negotiation skills.
  • Attention to detail and accuracy.
  • Excellent oral and written communication skills.
  • Ability to build and maintain relationships with internal and external Clients.
  • Technologically savvy, able to navigate current computer system; proprietary client systems and internet programs with speed and efficiency.
  • Excellent organization skills which includes ability to multi-task; prioritize and maintain a diary / calendar system.
  • Must be a self-starter with the ability to work independently and as part of a team.

Specialized Knowledge, Licenses, etc.:
Demonstrated proficiency in:
  • Desire to pursue professional designations, such as AIC, ARM, CPCU (Preferred but not required).
  • Ability to obtain New Mexico Adjuster License (Required)
  • MS Word and Outlook (Required) MS Excel and PowerPoint (Preferred)
  • Adobe (Preferred)

Values and Mission:
Adhere to values and mission by demonstrating Service Excellence, Trust, Ownership, One Team and Boldness in thought and action.
Positive Attitude:
Develops and maintains positive working relationships with team members, customers, co-workers and management by demonstrating effective communication and collaborative skills.
Working Conditions:
  • Integrion Group maintains general office conditions with light physical demands.
  • Employees of Integrion Group adhere to all safety rules and regulations including building security.
  • Employees participate in ensuring safe and efficient operating conditions that safeguard employees and facilities.
  • Integrion Group maintains a drug free environment; drug testing prior to employment as well as upon a work related accident.
  • Exposure to VDT screens.
  • In-State travel is required.

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