Senior Claims Specialist

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

📋 Description

• Manage intricate and prominent Workers’ Compensation claims while adhering to company protocols

• Collaborate closely with case managers and legal representatives

• Oversee subrogation, litigation, and potential recovery of claims

• Negotiate settlements effectively

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

• Assess claim validity and compensability through thorough investigation and data collection

• Submit required documentation to state agencies

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

• Create and manage documented action plans with case and outcomes managers to minimize claim expenses

• Facilitate early return-to-work initiatives

• Report claims to excess carriers when necessary

• Keep customers and claimants informed about claim status

• Comply with client, carrier, and relevant state guidelines and regulations

• Engage in claims reviews as required

• Build and sustain professional customer relationships

• Adhere to workplace safety regulations

• Execute additional responsibilities as assigned

⛳️ Requirements

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

• At least 3 years of experience in the industry and handling claims

• Preferred: Self-Insured Certificate

• State Certification or license as a seasoned claims adjuster

• Must maintain a current license or certification in Workers’ Compensation throughout employment with CorVel

• Outstanding written and verbal communication abilities

• Capacity to assist team members in enhancing their knowledge of claims practices

• Proficient in identifying, analyzing, and resolving issues

• Computer savvy with technical skills, including proficiency in Microsoft Office and Excel

• Strong interpersonal, time management, and organizational skills

• Ability to work autonomously as well as collaboratively in a team setting

• Comprehensive understanding of claims administration, case management, and cost containment strategies pertinent 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

• 401(k)

• Roth 401(k)

• Paid time off

• Opportunities for career advancement

• Supportive work culture

• Remote work options