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 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.

• Establish reserves and approve payments within the limits of reserving authority.

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

• Coordinate efforts for early return-to-work initiatives.

• Oversee subrogation and litigation processes as necessary.

• Manage potential recoveries from claims.

• Report claims to excess carriers when required.

• Update customers and claimants on the status of their claims.

• Follow client and carrier guidelines and engage 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 a combination of education and relevant experience.

• A minimum of 3 years of industry experience and claims handling expertise.

• Self-Insured Certificate is preferred.

• State Certification or license as a seasoned 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 enhancing their knowledge and understanding of claims practices.

• Proficient in identifying, analyzing, and resolving problems.

• Computer proficiency and technical aptitude are required.

• Skilled in Microsoft Office, particularly with Excel spreadsheets.

• Strong interpersonal abilities, along with time management and organizational skills.

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

• Understanding of claims administration, case management, and cost containment strategies applicable to Workers’ Compensation.

🏝️ Benefits

• Medical (HDHP) with Pharmacy coverage.

• Dental insurance.

• Vision insurance.

• Long Term Disability coverage.

• Health Savings Account options.

• Flexible Spending Account options.

• Life Insurance.

• Accident Insurance.

• Critical Illness Insurance.

• Pre-paid Legal Insurance.

• Parking and Transit FSA accounts.

• 401K plan.

• ROTH 401K option.

• Paid time off.

• Opportunities for career advancement.

• Remote work position.

• Supportive workplace culture.