Senior Medical Only Claims Representative - Workers Compensation

Great American Insurance GroupPA Work At Home, CT
$65,000 - $75,000Remote

About The Position

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. 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. 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”. 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!

Requirements

  • At least 2 years of experience handling medical only claims is required
  • 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

Nice To Haves

  • Prefer candidates have current license(s) to adjust workers’ compensation claims in Delaware, Connecticut, or New Hampshire or willingness to obtain same

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 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

Benefits

  • medical, dental, and vision coverage
  • wellness plans
  • parental leave
  • adoption assistance
  • tuition reimbursement
  • Paid Time Off
  • paid holidays
  • a 401(k) plan with company match
  • an employee stock purchase plan
  • commuter benefits
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