Remote Medical-Only Claims Specialist

EMC Insurance Companies; Oregon; Hybrid; USD 47,000 - 71,000; Full time

Job summary

EMC Insurance Companies is seeking a claims professional to manage medical-only workers’ compensation claims across jurisdictions. You will verify coverage, communicate with insureds and witnesses, and manage return-to-work programs and cost-containment resources.

You'll handle reserve setting, documentation, and timely payments while staying current on regulatory requirements and licensure. Flexible remote work is available across the United States.

Qualifications

• Experience in insurance or claims handling is preferred or related field.
• Ability to obtain state licenses within six months of hire.
• Bachelor’s degree may substitute for some experience.
• Strong written and verbal communication and attention to detail.

Responsibilities

• Investigates and manages medical-only workers’ compensation claims across jurisdictions.
• Communicates with insureds, employees, agents, and witnesses to gather information and provide updates.
• Verifies coverage, deductibles, and required documentation; prepares denials with approval.
• Establishes reserves, documents claims, and processes payments within authority.
• Stays current on medical treatment and workers’ comp requirements; supports risk reporting.

Skills

Communication skills

Organizational skills

Customer service

Problem solving

Multi-tasking

Education

Associate degree or equivalent experience

Bachelor's degree considered

Licenses within six months

Tools

Computers

Job description

EMC Insurance Companies is seeking a claims professional to manage medical-only workers’ compensation claims across jurisdictions. You will verify coverage, communicate with insureds and witnesses, and manage return-to-work programs and cost-containment resources.

You'll handle reserve setting, documentation, and timely payments while staying current on regulatory requirements and licensure. Flexible remote work is available across the United States.