Senior Claims Specialist
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Job Description
Senior Claims Specialist managing complex workers’ compensation claims for CorVel, a national risk-management solutions provider. Investigating claims, managing litigation and recoveries, and negotiating outcomes remotely in California.
Responsibilities:
- Handle complex and high-profile Workers' Compensation claims following company standards
- Receive claims, confirm policy coverage, and acknowledge claims
- Investigate claims, determine validity and compensability, and file necessary documentation with state agencies
- Establish reserves and authorize payments within reserving authority limits
- Develop and manage documented action plans with case managers and outcomes managers to reduce claim costs
- Coordinate early return-to-work efforts
- Manage subrogation and litigation
- Manage potential claim recoveries
- Report claims to the excess carrier when applicable
- Communicate claim status with customers and claimants
- Adhere to client and carrier guidelines and participate in claims reviews
- Develop and maintain professional customer relationships
- Comply with applicable state rules, regulations, and safety requirements
- Perform additional duties as assigned
Requirements:
- Bachelor's degree or a combination of education and related experience
- Minimum of 3 years’ industry experience and claim handling
- Self-Insured Certificate preferred
- State Certification or license as an experienced claims adjuster
- Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel
- Excellent written and verbal communication skills
- Ability to assist team members to develop knowledge and understanding of claims practice
- Ability to identify, analyze and solve problems
- Computer proficiency and technical aptitude, including Microsoft Office and Excel spreadsheets
- Strong interpersonal, time management and organizational skills
- Ability to work independently and within a team environment
- Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation
- Must reside in California
Benefits:
- Medical (HDHP) w/Pharmacy
- Dental
- Vision
- 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
- Remote work
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