Senior Claims Specialist

This is a fully remote position, open to applicants in California.

📋 Description

• Manage intricate and high-stakes Workers’ Compensation claims in accordance with company protocols.

• Receive Workers’ Compensation claims, verifying policy coverage and acknowledgment of the claim.

• Assess the validity and compensability of claims through thorough investigation and data collection.

• Submit required documentation to state agencies.

• Set reserves and authorize payments within the established reserving authority limits.

• Create and oversee documented action plans with case managers and outcomes managers to minimize claim costs.

• Facilitate early return-to-work initiatives.

• Oversee subrogation processes and claim litigation.

• Handle potential claim recoveries.

• Notify excess carriers of claims when necessary.

• Provide updates on claim status to customers and claimants.

• Follow client and carrier guidelines and engage in claims reviews.

• Build and sustain professional relationships with customers.

• Adhere to relevant state regulations and workplace safety standards.

⛳️ Requirements

• Bachelor’s degree or equivalent combination of education and relevant experience.

• At least 3 years of industry experience in claims handling.

• Self-Insured Certificate is preferred.

• State Certification or license as an experienced claims adjuster is required.

• A current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel.

• Exceptional written and verbal communication abilities.

• Capability to assist team members in developing their knowledge and understanding of claims practices.

• Proficient in identifying, analyzing, and resolving issues.

• Strong computer skills and technical aptitude, particularly with Microsoft Office and Excel spreadsheets.

• Excellent interpersonal, time management, and organizational skills.

• Ability to work independently as well as collaboratively within a team.

• Comprehensive knowledge of claims administration, case management, and cost containment solutions related to Workers’ Compensation.

🏝️ Benefits

• Medical (HDHP) with Pharmacy coverage.

• Dental insurance.

• Vision insurance.

• Long Term Disability insurance.

• Health Savings Account.

• Flexible Spending Account options.

• Life Insurance.

• Accident Insurance.

• Critical Illness Insurance.

• Pre-paid Legal Insurance.

• Parking and Transit FSA accounts.

• 401K plan.

• ROTH 401K plan.

• Paid time off.

• Opportunities for career advancement.

• Supportive work culture.

• Option for remote work.