Remote Senior Medical-Only WC Claims Specialist

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Wellness program

Parental leave

Adoption assistance

Tuition reimbursement

Paid time off

Paid holidays

401(k) match

Employee stock purchase plan

Commuter benefits

Job summary

Great American Insurance Group is seeking a Senior Claims Representative focused on medical-only workers' compensation. This fully remote role serves injured workers, employers, and providers across Texas, Arkansas, and Oklahoma, handling claims from initial report to resolution with accuracy and customer focus.

You will verify coverage, review medical bills, reserve claims up to $10,000, and collaborate with internal partners to achieve timely resolutions.

Qualifications

• High school diploma required.
• Minimum 2 years' experience handling workers’‑compensation medical‑only claims.
• Experience handling TX, AR, OK claims preferred.
• Strong knowledge of workers’ compensation claims handling, medical bill review, and investigation techniques.
• Ability to work independently in a remote environment.

Responsibilities

• Investigate, manage, and resolve medical-only WC claims from reporting through resolution.
• Verify coverage and determine compensability and handling strategy.
• Maintain regular communication with injured workers, employers, medical providers, and stakeholders.
• Approve/deny medical invoices per guidelines and regs.
• Manage claim reserves within authority up to $10,000.
• Ensure timely documentation and file management.

Skills

WC claims handling

Medical bill review

Claim investigation

Remote work

Education

High school diploma

Job description

Great American Insurance Group is seeking a Senior Claims Representative focused on medical-only workers' compensation. This fully remote role serves injured workers, employers, and providers across Texas, Arkansas, and Oklahoma, handling claims from initial report to resolution with accuracy and customer focus.

You will verify coverage, review medical bills, reserve claims up to $10,000, and collaborate with internal partners to achieve timely resolutions.