Senior Medical Claims Representative – Workers Compensation

Cisco

Senior Medical Only Claims Representative managing medical only claims in workers’ compensation for Great American Insurance. Investigating, managing, and resolving claims with multiple stakeholders.

Posted 7/10/2026full-timeRemote • Connecticut, New Hampshire, New Jersey, Pennsylvania • 🇺🇸 United StatesSenior💰 $65,000 - $75,000 per yearWebsite

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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

Benefits

Comp & perks

medical, dental, and 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

ATS Keywords

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Applicant Tracking System Keywords

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

Hard Skills & Tools

Claims ManagementCoverage VerificationPayment Approval AuthorityCase Reserve DeterminationMedical Invoice Processing

Soft Skills

Excellent CommunicationAccuracySpeedSelf-Motivation

Certifications

Workers' Compensation Claims Adjustment License