Remote Senior Medical-Only Claims Specialist

Great American Insurance Group; Ohio; Remote; USD 65,000 - 80,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

401(k) with company match

Paid time off

Holidays

Employee stock purchase plan

Commuter benefits

Tuition reimbursement

Job summary

Great American Insurance Group is seeking a Senior Medical Only Claims Representative to investigate, manage and resolve workers’ compensation medical-only claims across multiple Midwest states in a fully remote role. You will communicate with injured workers, employers and providers, set reserves, and ensure compliance with regulations while handling a high-volume caseload.

Preferred candidates have at least 2 years of medical-only claims experience and strong knowledge of claims handling

Qualifications

• Minimum 2 years of experience handling workers’ compensation medical-only claims.
• Experience in Minnesota, Iowa, Nebraska, South Dakota, Kansas and Missouri preferred.
• Strong written and verbal communication skills with remote work capability.

Responsibilities

• Investigate, evaluate, and manage medical-only workers’ compensation claims from reporting to resolution.
• Verify coverage and determine compensability and handling strategies.
• Maintain regular communication with injured workers, employers, providers, and stakeholders.
• Approve/deny medical invoices per guidelines and regulations.
• Establish and manage claim reserves within delegated authority.
• Ensure accurate documentation and file management.
• Analyze medical information to support effective outcomes and cost control.
• Handle claims across Minnesota, Iowa, Nebraska, South Dakota, Kansas and Missouri remotely.

Skills

Claims handling

Remote work

Communication

Education

High school diploma

Job description

Great American Insurance Group is seeking a Senior Medical Only Claims Representative to investigate, manage and resolve workers’ compensation medical-only claims across multiple Midwest states in a fully remote role. You will communicate with injured workers, employers and providers, set reserves, and ensure compliance with regulations while handling a high-volume caseload.

Preferred candidates have at least 2 years of medical-only claims experience and strong knowledge of claims handling