Senior Claims Representative – Medical Only, Workers Compensation
Core
Investigate, manage, and resolve workers' compensation medical-only claims with accuracy and efficiency.
Role type
Senior claims representative (medical-only)
Builds
Resolved claims and cost management for injured workers and employers
Domain
Insurance / Workers' Compensation
Required skills
Workers' compensation claims handling, medical bill review, claim investigation, reserve management, state-specific regulations compliance, high-volume case management
Preferred skills
Experience in Minnesota, Iowa, Nebraska, South Dakota, Kansas, Missouri, additional insurance/claims education
Technologies
None stated
Responsibilities
Investigate and evaluate medical-only claims from reporting to resolution; Verify coverage and determine compensability; Approve or deny medical invoices; Establish and manage claim reserves up to $10,000; Analyze medical information for cost management; Handle claims in specific Midwestern jurisdictions; Prioritize high-volume caseload
Seniority
Senior, hands-on IC