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Senior Medical Only Claims Representative - Workers Compensation

Role overview

Qualifications

  • At least 2 years of experience handling medical only claims
  • Prefer candidates have current license(s) to adjust workers’ compensation claims in Delaware, Connecticut, or New Hampshire or willingness to obtain same
  • Excellent communication skills required, in both written and verbal form
  • Must be self-motivated as this is a work-from-home position

Responsibilities

  • Investigate and manage all aspects of a medical only claim, maintaining phone/written contact with all necessary parties
  • Verify coverage, investigate, manage, and resolve medical only claims promptly and accurately
  • Authority to approve or deny payment of medical invoices, and determine case reserves, with up to $10,000 in reserve approval authority
  • Required to handle medical only claims in Maryland, New Jersey, and Pennsylvania

Other skills

  • Time Management
  • Communication
  • Problem Solving
  • Multitasking
  • Willingness To Learn
  • Self-Motivation

About the company

Great American Insurance Company logo

Great American Insurance Company

Insurance

Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance, focusing on specialty commercial products for businesses. We have more than 30 specialty property and casualty insurance businesses, and in 2021, approximately 50% of our gross written premium in our property and casualty operations was generated by business units with a Top 10 market ranking. Great American Insurance Company has received an "A" (Excellent) or higher rating from the AM Best Company for more than 110 years (most recent rating evaluation of "A+" (Superior) affirmed December 16, 2022). The members of Great American Insurance Group are subsidiaries of American Financial Group, Inc. (AFG), also based in Cincinnati, Ohio.

Company details

Company typeXLarge
IndustryInsurance
Company size5001 - 10000

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Job description

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.


This position is not eligible for employment visa sponsorship. Applicants must be authorized to work in the United States without the need for current or future sponsorship.

When is the last time you felt like you made a difference to your employer and in the job you do? Been awhile? Never? Our employees at Strategic Comp DO make a difference and feel appreciated for it. In fact we received 98% rating for overall job satisfaction from the participants in our last employee survey. This clearly indicates the passion and energy our staff has for our company and for the job they do!

Currently we have an opening for a work-from-home Senior Medical Only Claims Representative in your territory. Are you organized with good time management skills? Are you able to multi-task while remaining calm, focused, and able to prioritize?  Does this sound like you? If so, this might be the right job for you.

Here’s who we are. Strategic Comp is part of Great American Insurance Group, which was established in 1872. Based in Cincinnati, Ohio, the operations of Great American Insurance Group are engaged primarily in property and casualty insurance focusing on specialty commercial products for businesses.  The members of the Great American Insurance Group are subsidiaries of American Financial Group, Inc. AFG’s common stock is listed and traded on the New York Stock Exchange (“NYSE”) and NASDAQ under the symbol “AFG”.

Here’s what we do. We insure workers’ compensation coverage for large companies, using our deductible program. Our service in claims and loss control is second to none. We’ve found that a large majority of our customers feel the way our employees do. Our renewal retention is 90+%, meaning our customers enjoy working with us too!

Responsibilities:

Here’s what you would be doing if hired for the Senior Medical Only Claims Representative position:

  • Investigate and manage all aspects of a medical only claim, maintaining phone/written contact with all necessary parties
  • Verify coverage, investigate, manage, and resolve medical only claims promptly and accurately 
  • Authority to approve or deny payment of medical invoices, and determine case reserves, with up to $10,000 in reserve approval authority 
  • Required to handle medical only claims in Maryland, New Jersey, and Pennsylvania with the largest volume of claims being Pennsylvania
  • Prefer candidates have experience handling medical only claims in the New England states or are willing to learn

Qualifications:

  • At least 2 years of experience handling medical only claims is required
  • Prefer candidates have current license(s) to adjust workers’ compensation claims in Delaware, Connecticut, or New Hampshire or willingness to obtain same
  • Excellent communication skills required, in both written and verbal form
  • Must be able to work with accuracy and speed with a variety of internal and external contacts
  • Must be self-motivated as this is a work-from-home position
  • A high school diploma is required

#LI-StrategicComp

Business Unit:

Strategic Comp


Salary Range:

$65,000.00 -$75,000.00

Benefits:

We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.

 

Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.

 

*Excludes seasonal employees and interns.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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