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

• Collaborate closely with case managers and legal representatives

• Receive and assess claims, confirm policy coverage, and acknowledge receipt of claims

• Investigate claims to ascertain their validity and compensability, and submit required documentation to state agencies

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

• Develop and oversee documented action plans with case managers and outcomes managers aimed at minimizing claim expenses

• Facilitate early return-to-work initiatives

• Oversee subrogation, litigation, and potential recoveries related to claims

• Notify excess carriers of claims when applicable

• Update customers and claimants regarding claim status

• Comply with client, carrier, state, and safety regulations

• Build and maintain professional relationships with customers

• Engage in claims reviews as necessary

• Carry out additional duties as assigned

⛳️ Requirements

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

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

• Self-Insured Certificate is a plus

• State Certification or license as an experienced 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 colleagues in enhancing knowledge and understanding of claims practices

• Proficient in identifying, analyzing, and resolving issues

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

• 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 related 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

• Remote work