Senior Claims Representative – Medical Only, Workers Compensation

Great American Insurance Group

. Investigate, evaluate, and manage workers’ compensation medical-only claims from initial reporting through resolution .

Posted 10/16/2026full-timeRemote • Texas • United StatesSenior💰 $65,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing workers’ compensation medical-only claims, including compliance with state regulations and effective communication with stakeholders. Proven ability to analyze claims and medical information to support outcomes while maintaining accurate documentation and managing a high-volume caseload.

Highest-signal resume keywords

Workers’ Compensation Claims HandlingMedical Bill ReviewClaim Investigation TechniquesTexas, Arkansas, and Oklahoma Claims ManagementExcellent Written and Verbal Communication

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ManagementMedical Invoice ApprovalClaim DocumentationClaim Reserve ManagementCost Management AnalysisRegulatory ComplianceHigh-Volume Caseload ManagementClaim Handling StrategiesCompensability DeterminationIssue Escalation

Soft Skills

Effective Stakeholder InteractionIndependent WorkMulti-Priority ManagementTimely CommunicationCollaboration

Industry Keywords

Workers’ CompensationMedical-Only ClaimsState RegulationsClaims AdministrationInsurance EducationBusiness-Related Education

About the role

Key responsibilities & impact

Investigate, evaluate, and manage workers’ compensation medical-only claims from initial reporting through resolution
Verify coverage and gather relevant information to determine compensability and claim handling strategies
Communicate regularly with injured workers, employers, medical providers, and other stakeholders
Approve or deny medical invoice payments according to company guidelines and jurisdictional regulations
Establish and manage claim reserves within delegated authority, including approvals up to $10,000
Maintain timely and accurate claim documentation and file management
Analyze medical information and claim details to support claim outcomes and cost management
Handle medical-only claims in Texas, Arkansas, and Oklahoma in compliance with state regulations
Support claim administration in other jurisdictions as business needs require
Manage a high-volume caseload while meeting productivity, quality, and service expectations
Collaborate with internal partners and external stakeholders to resolve claims promptly and effectively
Identify issues requiring escalation and recommend actions to minimize risk and ensure compliance

Requirements

What you’ll need

High school diploma required; additional insurance, claims, or business-related education is preferred
Minimum of 2 years of experience handling workers’ compensation medical-only claims
Experience managing claims in Texas, Arkansas, and Oklahoma preferred
Experience managing claims in Minnesota, Kansas, Missouri, Iowa, Nebraska, and South Dakota is a plus
Strong knowledge of workers’ compensation claims handling practices, medical bill review, and claim investigation techniques
Excellent written and verbal communication skills
Ability to interact effectively with internal and external stakeholders
Ability to work independently in a remote environment
Ability to manage multiple priorities and maintain accuracy in a fast-paced setting
Must be authorized to work in the United States without current or future employment visa sponsorship

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Wellness plans
Parental leave
Adoption assistance
Tuition reimbursement
Paid Time Off
Paid holidays
401(k) plan with company match
Employee stock purchase plan
Commuter benefits