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 • United StatesSenior💰 $65,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing workers’ compensation medical-only claims, including claim investigation, medical bill review, and compliance with state-specific regulations. Proven ability to communicate effectively with various stakeholders while managing a high-volume caseload and ensuring timely claim resolution.

Highest-signal resume keywords

Workers’ Compensation Claims HandlingMedical Bill ReviewClaim Investigation TechniquesVerbal And Written Communication SkillsHigh-Volume Caseload Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claim DocumentationClaim Reserves ManagementCompensability DeterminationClaim Resolution ActivitiesMedical Information Analysis

Soft Skills

Independent WorkPrioritizationAttention To DetailCollaboration

Industry Keywords

Minnesota Workers’ CompensationIowa Workers’ CompensationNebraska Workers’ CompensationSouth Dakota Workers’ CompensationKansas Workers’ CompensationMissouri Workers’ Compensation

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 appropriate claim handling strategies
Maintain regular verbal and written communication with injured workers, employers, medical providers, and other claim stakeholders
Approve or deny payment of medical invoices in accordance with company guidelines and applicable jurisdictional regulations
Establish and manage claim reserves within delegated authority levels, including reserve approvals up to $10,000
Ensure timely and accurate claim documentation, file management, and resolution activities
Analyze medical information and claim details to facilitate effective claim outcomes and cost management
Handle medical-only claims in Minnesota, Iowa, Nebraska, South Dakota, Kansas and Missouri while maintaining compliance with state-specific regulations
Support claim administration in Midwestern jurisdictions as business needs require
Prioritize and manage a high-volume caseload while meeting productivity, quality, and service expectations
Collaborate with internal partners and external stakeholders to achieve prompt and effective claim resolution
Identify issues requiring escalation and recommend appropriate actions to minimize risk and ensure compliance

Requirements

What you’ll need

High school diploma required
Generally, a minimum of 2 years of experience handling workers’ compensation medical-only claims
Experience managing claims in Minnesota, Iowa, Nebraska, South Dakota, Kansas and Missouri preferred
Strong knowledge of workers’ compensation claims handling practices, medical bill review, and claim investigation techniques
Excellent written and verbal communication skills with the ability to effectively interact with a variety of internal and external stakeholders
Demonstrated ability to work independently in a remote environment, manage multiple priorities, and maintain accuracy in a fast-paced setting
Must be authorized to work in the United States without the need for 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