Senior Claims Specialist

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

📋 Description

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

• Receive claims, verify policy coverage, and acknowledge the claims received.

• Investigate claims to assess their validity and compensability, and submit necessary documentation to state agencies.

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

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

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

• Oversee claim subrogation, litigation, and potential recoveries.

• Report claims to excess carriers when appropriate.

• Communicate updates on claims status to customers and claimants.

• Comply with client, carrier, and relevant state guidelines, and participate in claims reviews.

• Foster and maintain professional relationships with customers.

• Adhere to safety regulations and rules.

• Execute additional responsibilities as assigned.

⛳️ Requirements

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

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

• Self-Insured Certificate is preferred.

• State certification or license as an experienced claims adjuster is required.

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

• Exceptional written and verbal communication skills.

• Capability to identify, analyze, and resolve problems.

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

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

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

• Knowledgeable in 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 company culture.