Senior Claims Representative – Medical Only, Workers Compensation

🔥 3 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $65k - $80k / year

⏰ Full Time

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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Great American Insurance Group

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🛡️ Insurance

🤝 B2B

Insurance • B2B

Great American Insurance Group is a U. S. -based specialty insurance company that provides a wide range of commercial insurance products and services to businesses and niche industries. With more than 150 years of history and headquarters in Cincinnati, Ohio, Great American offers tailored coverages including property & inland marine, equine mortality, transportation, professional liability, trade credit, cyber risk, and employer health solutions through numerous specialty divisions and international branches. It is a group of insurance companies that are subsidiaries of American Financial Group and emphasizes financial strength, claims expertise, and industry-focused underwriting for primarily business customers.

📋 Description

• Investigate, evaluate, and manage workers’ compensation medical-only claims from initial reporting through resolution • Verify coverage and gather relevant information to determine compensability and claim handling strategies • Communicate regularly with injured workers, employers, medical providers, and other stakeholders • Approve or deny medical invoice payments according to company guidelines and jurisdictional regulations • Establish and manage claim reserves within delegated authority, including approvals up to $10,000 • Maintain timely and accurate claim documentation and file management • Analyze medical information and claim details to support claim outcomes and cost management • Handle medical-only claims in Texas, Arkansas, and Oklahoma in compliance with state regulations • Support claim administration in other jurisdictions as business needs require • Manage a high-volume caseload while meeting productivity, quality, and service expectations • Collaborate with internal partners and external stakeholders to resolve claims promptly and effectively • Identify issues requiring escalation and recommend actions to minimize risk and ensure compliance

🎯 Requirements

• High school diploma required; additional insurance, claims, or business-related education is preferred • Minimum of 2 years of experience handling workers’ compensation medical-only claims • Experience managing claims in Texas, Arkansas, and Oklahoma preferred • Experience managing claims in Minnesota, Kansas, Missouri, Iowa, Nebraska, and South Dakota is a plus • Strong knowledge of workers’ compensation claims handling practices, medical bill review, and claim investigation techniques • Excellent written and verbal communication skills • Ability to interact effectively with internal and external stakeholders • Ability to work independently in a remote environment • Ability to manage multiple priorities and maintain accuracy in a fast-paced setting • Must be authorized to work in the United States without current or future employment visa sponsorship

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Wellness plans • Parental leave • Adoption assistance • Tuition reimbursement • Paid Time Off • Paid holidays • 401(k) plan with company match • Employee stock purchase plan • Commuter benefits