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FCCI Insurance Group

Medical Claim Adjuster

FCCI Insurance Group

Medical Claim Adjuster investigating workers' compensation claims and complying with regulations. Role includes communication with various stakeholders and ensuring proper claim management.

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

Core Competencies

Role fit
Core Competencies

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Demonstrates expertise in managing medical-only workers' compensation claims, ensuring compliance with relevant laws and regulations while providing quality customer service. Proficient in claim file management and medical terminology, with strong communication skills to engage with various stakeholders.

Highest-signal resume keywords
Florida Adjusters LicenseClaim File ManagementMedical TerminologyWorkers' Compensation Claims ProcessingCompliance with Laws and Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills
Claim ProcessingMedical Documentation ReviewStatutory FilingsClaims InvestigationClaims Monitoring
Soft Skills
CommunicationCustomer ServiceAttention to Detail
Certifications & Qualifications
Florida Adjusters License
Industry Keywords
Workers' CompensationCompensabilityMedical-Only ClaimsClaim Activity DocumentationJurisdictional Compliance

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.
  • 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

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