Remote Senior Medical-Only Claims Specialist

Great American Insurance Group; Texas; Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off and holidays

401(k) with company match

Employee stock purchase plan

Commuter benefits

Parental leave & adoption assistance

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 with accuracy and customer focus. The role primarily covers Texas, Arkansas, and Oklahoma and is fully remote, requiring a self-motivated professional who can manage priorities independently.

You will verify coverage, determine compensability, and communicate with injured workers, employers, medical providers, and stakeholders while

Qualifications

• High school diploma required; insurance, claims or business education preferred.
• Minimum of 2 years' experience handling workers’ compensation medical-only claims.
• Experience in Texas, Arkansas and Oklahoma preferred; other states a plus.
• Strong knowledge of workers’ compensation claims handling, medical bill review and investigations.
• Ability to work independently in a remote environment.

Responsibilities

• Investigate, evaluate, and manage workers’ compensation medical-only claims from initial reporting through resolution.
• Verify coverage and determine compensability and appropriate handling strategies.
• Maintain regular verbal and written communication with injured workers, employers, medical providers, and other stakeholders.
• Approve or deny payment of medical invoices per guidelines and jurisdictional rules.
• Manage claim reserves up to $10,000 within delegated authority.
• Ensure timely documentation and file management of all activities.
• Analyze medical information to support cost-effective outcomes.
• Handle claims in TX, AR, OK and assist in other jurisdictions as needed.

Skills

Workers’ compensation claims handling

Medical bill review

Claim investigation

Remote work

Time management

Education

High school diploma

Insurance/claims/business coursework preferred

Job description

Great American Insurance Group is seeking a Senior Medical Only Claims Representative to investigate, manage, and resolve workers’ compensation medical-only claims with accuracy and customer focus. The role primarily covers Texas, Arkansas, and Oklahoma and is fully remote, requiring a self-motivated professional who can manage priorities independently.

You will verify coverage, determine compensability, and communicate with injured workers, employers, medical providers, and stakeholders while