Medical Only Claims Adjuster at RCM&D

Working at RCM&D and SISCO is ideal for those seeking a challenging, rewarding and upwardly mobile career in risk management, insurance and employee benefits. Dedicated to fostering their continued success and growth, we are deeply invested in our employees.

RCM&D is currently searching for a Medical Only Claims Adjuster for SISCO. The successful candidate will be responsible for investigating and managing all aspects of medical only workers’ compensation claims in Maryland and surrounding jurisdictions in accordance with jurisdictional requirements to the best possible resolution.

A Day in the Life:

• 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.
• 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.
• Issue denial letters to providers and claimants when appropriate.

What You’ll Need:

• High school diploma or GED; some college preferred
• Possess 1 – 2 years’ experience performing the duties of this position or one with similar requirements.
• Excellent written and oral communication skills are necessary
• Must possess strong interpersonal skills and is able to work collaboratively with internal and external stakeholders; able to work independently or in concert with the team.

Who You Are:

• Exhibit strong time management skills; possess the ability to work under pressure and meet deadlines and deliverables. 
• Adept at interpreting data and information.
• Demonstrates a willingness to learn.
• Contributes to team efficiency by sharing knowledge and best practices.
• Able to deal with change and ambiguity
• Demonstrate agility and can multi-task, as well as pivot to changing priorities, as circumstances warrant.

What You’ll Get:

• Competitive salary DOE + comprehensive benefits
• Hybrid/Remote Work
• Flexible time off
• 401k stock match selection and profit sharing
• Employee ownership
• Tuition reimbursement

Finding and cultivating talent is a hallmark of our organization. RCM&D looks for the best and brightest risk management, insurance and employee benefits professionals to join our firm. As a growing and vibrant business, we also recruit savvy marketing, sales, finance, human resources, technology and administrative colleagues to manage and operate our business.