Senior Claims Specialist, CA Workers' Compensation

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

📋 Description

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

• Verify policy coverage and acknowledge claims submissions.

• Conduct investigations into claims to assess their validity and compensability, filing necessary documentation with state agencies.

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

• Create and oversee documented action plans in collaboration with case managers and outcomes managers to minimize claim costs.

• Facilitate early return-to-work initiatives.

• Handle subrogation and litigation matters as necessary.

• Oversee potential claim recoveries.

• Report claims to excess carriers when necessary.

• Keep customers and claimants informed about the status of 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.

• Undertake additional responsibilities as needed.

⛳️ Requirements

• Bachelor’s degree or a mix of education and related experience.

• At least 3 years of industry experience and claims handling expertise.

• Self-Insured Certificate is preferred.

• State certification or license as an experienced claims adjuster.

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

• Outstanding written and verbal communication abilities.

• Capability to support team members in enhancing their knowledge and understanding of claims practices.

• Proficiency in identifying, analyzing, and resolving issues.

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

• Strong interpersonal skills, along with effective 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 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.

• Remote work opportunities.

• Career advancement potential.

• Supportive workplace culture.