Senior Claims Specialist

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

📋 Description

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

• Collaborate closely with case managers and legal representatives.

• Receive Workers’ Compensation claims, verify policy coverage, and acknowledge claims.

• Conduct investigations into claims, assess their validity and compensability, and collect necessary information.

• Submit required documentation to state agencies.

• Set reserves and authorize payments within established reserving authority limits.

• Create and oversee documented action plans with case managers and outcomes managers to lower claim costs.

• Facilitate early return-to-work initiatives.

• Handle subrogation, litigation, and potential recovery of claims.

• Report claims to excess carriers when necessary.

• Update customers and claimants on claim status.

• Follow client and carrier guidelines, and participate in claims reviews.

• Build and maintain professional relationships with customers.

• Adhere to applicable state regulations and requirements.

• Perform other duties as assigned.

⛳️ Requirements

• Vermont adjuster license is mandatory.

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

• At least 3 years of industry experience and claim handling is necessary.

• 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 during employment with CorVel.

• Exceptional written and verbal communication abilities.

• Capacity to assist team members in developing knowledge and understanding of claims practices.

• Proficiency in identifying, analyzing, and resolving issues.

• Computer skills and technical aptitude, including proficiency in Microsoft Office and Excel spreadsheets.

• Strong interpersonal, time management, and organizational capabilities.

• Ability to work independently as well as in a collaborative team environment.

• Knowledge of claims administration, case management, and cost containment strategies relevant 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 plan.

• Paid time off.

• Opportunities for career advancement.

• Remote work arrangement.