Senior Claims Specialist

This is a fully remote position, open to applicants in Connecticut, +6 more states.

📋 Description

• Manage intricate and high-stakes Workers’ Compensation claims in alignment with company protocols

• Collaborate closely with case managers and legal counsel

• Receive claims, verify policy coverage, and confirm receipt of claims

• Investigate claims to assess their validity and eligibility for compensation

• Collect information and submit required documentation to state agencies

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

• Create and oversee documented action plans in partnership with case managers and outcomes managers

• Coordinate initiatives for early return-to-work

• Oversee subrogation and litigation processes

• Manage potential recoveries from claims

• Report claims to excess carriers when necessary

• Update customers and claimants on the status of claims

• Comply with client and carrier guidelines while participating in claims reviews

• Build and sustain professional relationships with customers

• Adhere to relevant state laws and regulations

• Assist the Claims Department and contribute to CorVel objectives

• Execute additional responsibilities as assigned

⛳️ Requirements

• Required: CT, MA, NH, or RI license and/or relevant experience

• Preferred: ME and VT license along with experience

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

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

• Self-Insured Certificate is preferred

• State certification or license as a seasoned claims adjuster

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

• Exceptional written and verbal communication abilities

• Competence in identifying, analyzing, and resolving issues

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

• Strong interpersonal, time management, and organizational capabilities

• Ability to operate independently as well as collaboratively within a team

• Familiarity with claims administration, case management, and cost containment practices for 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

• Career advancement opportunities

• Supportive company culture