Senior Claims Specialist

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

📋 Description

• Manage intricate and high-profile Workers’ Compensation claims in accordance with company standards.

• Receive claims, verify policy coverage, and acknowledge claims promptly.

• Conduct investigations on claims to assess validity and compensability, and prepare necessary documentation for state agencies.

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

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

• Facilitate early return-to-work initiatives.

• Oversee subrogation and litigation processes.

• Handle potential claim recoveries.

• Notify excess carriers of claims when applicable.

• Provide updates on claim status to customers and claimants.

• Comply with client and carrier guidelines and take part in claims reviews.

• Build and maintain professional relationships with customers.

• Adhere to relevant state rules, regulations, and workplace safety standards.

• Execute additional responsibilities as assigned.

⛳️ Requirements

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

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

• Self-Insured Certificate is preferred.

• State Certification or license as an experienced claims adjuster.

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

• Exceptional written and verbal communication skills.

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

• Proficiency in identifying, analyzing, and resolving problems.

• Competence in computer applications and technical skills, including Microsoft Office and Excel spreadsheets.

• Strong interpersonal, time management, and organizational abilities.

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

• Familiarity with claims administration, case management, and cost containment solutions relevant to Workers’ Compensation.

🏝️ Benefits

• Medical (HDHP) with Pharmacy.

• Dental insurance.

• Vision insurance.

• Long Term Disability.

• Health Savings Account.

• Flexible Spending Account options.

• Life Insurance.

• Accident Insurance.

• Critical Illness Insurance.

• Pre-paid Legal Insurance.

• Parking and Transit FSA accounts.

• 401K.

• ROTH 401K.

• Paid time off.

• Opportunities for career advancement.

• Remote work options.