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

• Collaborate closely with case managers and legal professionals

• Oversee subrogation, litigation, and potential claim recoveries

• Negotiate settlement agreements

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

• Conduct investigations to assess claims, determine their validity and compensability, and submit necessary 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 costs

• Facilitate early return-to-work initiatives

• Report claims to excess carriers when appropriate

• Update customers and claimants on claim status

• Adhere to client, carrier, state, and workplace safety standards

• Foster and maintain professional relationships with customers

• Take part in claims reviews as necessary

• 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 and claims handling

• Self-Insured Certificate is preferred

• State certification or license as an experienced claims adjuster

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

• Outstanding written and verbal communication abilities

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

• Skills to identify, analyze, and resolve issues

• Proficient in computer use and technical skills, including Microsoft Office and Excel spreadsheets

• Strong interpersonal, time management, and organizational capabilities

• Ability to work autonomously as well as collaboratively within a team

• Familiarity with claims administration, case management, and cost containment strategies 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

• Career advancement opportunities

• Supportive culture

• Remote work