Medical Claim Adjuster

FCCI Insurance Group

Medical Claim Adjuster at FCCI responsible for evaluating and managing workers' compensation medical-only claims. Ensuring compliance and effective communication with involved parties.

Posted 7/8/2026full-timeSarasota • Florida, Mississippi, Virginia • 🇺🇸 United StatesJuniorMid-Level💰 $23 - $35 per hourWebsite

About the role

Key responsibilities & impact

Investigate and determine compensability for assigned medical-only workers' compensation claims in multiple jurisdictions.
Review medical documentation and monitor treatment to ensure ongoing care is related to the work injury.
Document claim activity, maintain claim files, and establish appropriate reserves.
Process benefits and complete required statutory filings in compliance with applicable laws and regulations.
Communicate with injured workers, employers, medical providers, and agency partners.
Escalate and transfer claims as appropriate based on claim complexity and company guidelines.
Manage claims efficiently while ensuring accuracy, compliance, and quality customer service.

Requirements

What you’ll need

High School diploma or equivalent
Minimum of two years’ experience in claim/medical processing work
Basic working knowledge of relevant laws, procedures, rules and regulations.
Solid working knowledge of claim file management techniques and processes.
Solid working knowledge of medical terminology.
Excellent communication, negotiation, interpersonal and organizational skills.
Ability to explain insurance policy coverage as applicable to the area of claims handling.
Current, active Florida Adjusters License

Benefits

Comp & perks

Flexible Work Environment
Paid Family Leave
Competitive PTO & Holidays
Recognition & Bonus Programs
Medical, Vision, Dental & Life Insurance
Employee Referral Bonus
Paid Volunteer Time
401(k) Match & Profit-Sharing

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Claims ProcessingMedical Documentation ReviewStatutory FilingsCompensability InvestigationClaims Activity Documentation

Soft Skills

Excellent Communication SkillsNegotiation SkillsInterpersonal SkillsOrganizational Skills

Certifications

Florida Adjusters License