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Senior Claims Representative Jobs (NOW HIRING)

Gaig

Senior Claims Representative

Tulsa, OK · Hybrid

We are seeking an experienced casualty claims professional to join our team as a Senior Claims Representative. The position will work a hybrid schedule in our downtown office in Tulsa, Oklahoma, or ...

Gaig

Senior Claims Representative

Cincinnati, OH · Hybrid

We are seeking an experienced casualty claims professional to join our team as a Senior Claims Representative. The position will work a hybrid schedule in our downtown office in Tulsa, Oklahoma, or ...

Gaig

Senior Claims Representative

Cincinnati, OH · Hybrid

We are seeking an experienced casualty claims professional to join our team as a Senior Claims Representative. The position will work a hybrid schedule in our downtown office in Tulsa, Oklahoma, or ...

Gaig

Senior Claims Representative

Tulsa, OK · Hybrid

We are seeking an experienced casualty claims professional to join our team as a Senior Claims Representative. The position will work a hybrid schedule in our downtown office in Tulsa, Oklahoma, or ...

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Senior Claims Representative information

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How much do senior claims representative jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for senior claims representative in the United States is $24.12, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $27.40 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a senior claims representative, and why are they important?

To thrive as a Senior Claims Representative, you need in-depth knowledge of insurance policies, claims adjudication, and investigative techniques, usually backed by relevant experience or a related degree. Familiarity with claims management systems, regulatory compliance tools, and sometimes industry certifications like AIC or CPCU is typically expected. Excellent negotiation, analytical thinking, and customer service skills help build trust and resolve complex claims efficiently. These abilities ensure accurate, fair, and timely claims processing, maintaining customer satisfaction and minimizing organizational risk.

What is the difference between Senior Claims Representative vs Claims Adjuster?

AspectSenior Claims RepresentativeClaims Adjuster
Required CredentialsHigh school diploma or equivalent; often some insurance certificationsHigh school diploma or equivalent; insurance licenses often required
Work EnvironmentOffice setting, claims departmentField or office-based, investigating claims
Employer & Industry UsageInsurance companies, claims departmentsInsurance companies, third-party administrators
Common Search & ComparisonSenior Claims Representative vs Claims Adjuster

The main difference is that Senior Claims Representatives often handle more complex claims and may have additional responsibilities, while Claims Adjusters focus on investigating and settling claims, sometimes in the field. Both roles require similar credentials and work within insurance companies, but Senior Claims Representatives typically have more experience and authority in decision-making.

What does a senior claims representative do?

A Senior Claims Representative is responsible for handling complex insurance claims, investigating and evaluating them, and determining the extent of the insurance company’s liability. They review documentation, interview claimants and witnesses, and negotiate settlements in accordance with company and legal guidelines. In addition, they may mentor junior staff and ensure that claims are processed efficiently and in compliance with policies. Their role is critical in ensuring fair outcomes for both the insurer and the insured.

What are some common challenges faced by senior claims representatives, and how can they effectively manage complex claims?

Senior Claims Representatives often handle high-value or intricate claims that require thorough investigation, negotiation, and adherence to regulatory guidelines. Challenges can include managing multiple cases simultaneously, working with difficult claimants, and balancing the interests of clients, policyholders, and the company. Effective management involves strong organizational skills, continuous communication with stakeholders, and staying current with industry best practices. Collaboration with legal teams, adjusters, and underwriters is also crucial to ensure fair and timely resolutions.
More about Senior Claims Representative jobs
What cities are hiring for Senior Claims Representative jobs? Cities with the most Senior Claims Representative job openings:
What are the most commonly searched types of Claims Representative jobs? The most popular types of Claims Representative jobs are:
What states have the most Senior Claims Representative jobs? States with the most job openings for Senior Claims Representative jobs include:
What job categories do people searching Senior Claims Representative jobs look for? The top searched job categories for Senior Claims Representative jobs are:
Senior Claims Representative jobs near you
Infographic showing various Senior Claims Representative job openings in the United States as of August 2026, with employment types broken down into 85% Full Time, 13% Part Time, and 2% Contract. Highlights an 72% Physical, 1% Hybrid, and 27% Remote job distribution, with an average salary of $50,180 per year, or $24.1 per hour.

Senior Claims Representative (Remote)

Missouri Employers Mutual Insurance

Remote

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 2 days ago

Job description

Senior Claims Representative

Are you a seasoned claims professional with a passion for navigating complex cases? MEM Insurance is seeking a Senior Claims Representative to join our Claims team. In this pivotal role, you'll manage high-exposure workers' compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes. You'll be a key decision-maker, a mentor to junior adjusters, and a champion of process improvement—all while ensuring exceptional service and regulatory compliance.

At MEM Insurance, we don't just protect our customers—we empower our employees. We foster a culture of integrity, collaboration, and innovation. Our team thrives on solving challenges together, supporting one another, and making a meaningful impact in the lives of our policyholders and injured workers.

Essential Duties and Responsibilities
  • Manage highly complex claims involving significant financial exposure, legal intricacies, and extended life cycles.
  • Conduct advanced investigations into coverage and compensability, including nuanced statutory interpretations.
  • Oversee medical case management for catastrophic injuries and lifetime care needs.
  • Review and authorize large or complex medical bills, negotiating adjustments to control costs.
Return-to-Work Management
  • Develop comprehensive RTW strategies in collaboration with policyholders, legal counsel, and vocational consultants.
  • Ensure precision in benefit calculations for high-exposure claims, addressing tax and compliance risks.
  • Strategically deploy investigative efforts aligned with broader claims strategy.
Claims Investigation & Loss Prevention
  • Lead investigations into complex fraud cases and collaborate with the Special Investigations Unit.
  • Conduct subrogation analysis and negotiate with third-party insurers or attorneys for maximum recovery.
Settlements & Negotiation
  • Partner with legal teams to negotiate complex settlements and manage litigation processes.
  • Oversee Medicare compliance initiatives, including Medicare Set-Asides and CMS engagement.
  • Identify opportunities for structured settlements and lead negotiations.
Reporting
  • Produce strategic reports on high-profile claims to guide management decisions.
  • Maintain system data integrity and prepare claims for Corporate Plan of Action meetings.
Collaboration
  • Lead cross-departmental efforts to improve claims handling and risk management.
  • Resolve escalated customer service issues and support high-value accounts.
  • Participate in workflow improvement initiatives and committees.
Team Leadership
  • Mentor and coach junior and intermediate adjusters.
  • Review escalated claims and provide actionable feedback.
  • Support workforce development and succession planning.
Qualifications:
  • Bachelor's degree in business or related field preferred, or equivalent industry experience.
  • 7–10 years of claims handling experience, with high exposure to Workers' Compensation.
  • Associate in Claims (AIC), AIM, or CPCU designation preferred or ability to obtain.
  • Texas All-Lines license preferred.
  • Valid driver's license required.
Company Culture and Values

At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other's growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.

Connection and Belonging

MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.

Total Rewards Overview
  • Health Plans: Medical, Dental, and Vision Includes fertility benefits, fully paid preventative care, and adult orthodontia.
  • Employer-Paid Life and Disability Benefits: Life Insurance (3x base salary), AD&D, Short and Long-term Disability.
  • Wellness and Recognition Program: Employer-paid incentives for employees and spouses.
  • Flexible Spending Account and Dependent Care options
  • Health Savings Account: Generous employer contribution.
  • Time Away from Work: Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave.
  • Employee Assistance Programs
  • 401k Retirement Plan: Employer match and profit sharing.
  • Adoption Assistance and Tuition Assistance

Notice Regarding Use of Artificial Intelligence MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.

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