Remote Senior Medical-Only Claims Specialist

Great American Insurance Group; Illinois; Remote; USD 70.000 - 92.000; Vollzeit

Benefits dieser Stelle

Medical, dental, and vision coverage

Wellness plans

Parental leave

Tuition reimbursement

Paid time off and paid holidays

401(k) plan with company match

Employee stock purchase plan

Commuter benefits

Zusammenfassung

SCI Summit Consulting, LLC is seeking a Senior Medical Only Claims Representative for a remote role based in Illinois. The candidate will manage medical-only workers’ compensation claims, conduct investigations, determine liability and settlements, and communicate with insureds and external partners.

Requires 5+ years in property and casualty claims and knowledge of coverage and procedures. Education includes a Bachelor’s degree in a related field; AIC or similar designation is a plus.

Qualifikationen

• Bachelor’s degree or equivalent experience in a related field.
• Minimum 5 years of property and casualty claims handling experience.
• Professional designation such as AIC preferred.
• Strong analytical, negotiation, and problem-solving abilities.
• Knowledge of insurance policies, coverage, and claims procedures.

Aufgaben

• Manage an inventory of medical-only claims to evaluate compensability and liability.
• Plan and conduct claim investigations to confirm coverage and liability.
• Negotiate settlements and reserves within authority; may attend arbitrations or depositions.
• Communicate complex coverage and settlement information to insureds, claimants and partners.
• Authorize payments within authority and ensure timely processing.
• Maintain accurate claim files with correspondence, reports, and settlements.

Kenntnisse

Analytical skills

Negotiation

Communication

Organization

Ausbildung

Bachelor's Degree in Business Administration, Risk Management and Insurance, Finance, or related field

Jobbeschreibung

SCI Summit Consulting, LLC is seeking a Senior Medical Only Claims Representative for a remote role based in Illinois. The candidate will manage medical-only workers’ compensation claims, conduct investigations, determine liability and settlements, and communicate with insureds and external partners.

Requires 5+ years in property and casualty claims and knowledge of coverage and procedures. Education includes a Bachelor’s degree in a related field; AIC or similar designation is a plus.