Senior Claims Specialist

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

📋 Description

• Manage intricate and prominent Workers’ Compensation claims in accordance with company protocols.

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

• Conduct investigations into claims, assessing their validity and compensability, collecting necessary information, and submitting required documentation to state agencies.

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

• Create and oversee documented action plans alongside case managers and outcomes managers to mitigate claim costs.

• Facilitate early return-to-work initiatives.

• Oversee subrogation, litigation, and potential claim recoveries.

• Report claims to excess carriers when necessary.

• Communicate the status of claims to customers and claimants.

• Follow client and carrier guidelines, actively participating in claims reviews.

• Build and sustain professional relationships with customers.

• Adhere to relevant state regulations and workplace safety standards.

• Execute additional responsibilities as assigned.

⛳️ Requirements

• Bachelor’s degree or an 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.

• 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 enhancing their knowledge and understanding of claims practices.

• Proficiency in identifying, analyzing, and resolving problems.

• Computer proficiency and technical aptitude, including familiarity with Microsoft Office and Excel spreadsheets.

• Strong interpersonal, organizational, and time management skills.

• Ability to work both independently and collaboratively within a team.

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

🏝️ Benefits

• Medical (HDHP) with Pharmacy.

• Dental.

• Vision.

• 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.

• Career advancement opportunities.

• Remote position.

• Equal Opportunity Employer.

• Drug-free workplace.