Senior Claims Specialist - NY jobs in United States
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CorVel Corporation · 2 days ago

Senior Claims Specialist - NY

CorVel Corporation is a national provider of industry-leading risk management solutions for workers’ compensation and other industries. The Senior Claims Specialist handles complex Workers' Compensation claims, working closely with case managers and attorneys to ensure optimal outcomes and customer service.

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Responsibilities

Receives claim, confirms policy coverage and acknowledgement of the claim
Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies
Establishes reserves and authorizes payments within reserving authority limits
Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim
Coordinates early return-to-work efforts with the appropriate parties
Manages subrogation and litigation of claim as it applies
Manages potential claim recoveries of all types
Reports claims to the excess carrier when applicable
Communicates claim status with the customer and claimant
Adheres to client and carrier guidelines and participates in claims review as needed
Develops and maintains professional customer relationships
Complies with rules and regulations of applicable state
Additional duties as assigned

Qualification

Claims administration knowledgeWorkers' Compensation expertiseMS Office proficiencyProblem-solving abilityWritten communication skillsVerbal communication skillsInterpersonal skillsTime management skillsOrganizational skillsTeamwork abilityIndependent work ability

Required

Handles complex and high-profile Workers' Compensation claims following company standards
Works closely with case managers and attorneys
Manages subrogation and negotiates settlements
Ensures the best possible outcome for the claim
Meets customer service expectations
Supports the goals of the Claims Department and CorVel
Receives claim, confirms policy coverage and acknowledgement of the claim
Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies
Establishes reserves and authorizes payments within reserving authority limits
Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim
Coordinates early return-to-work efforts with the appropriate parties
Manages subrogation and litigation of claim as it applies
Manages potential claim recoveries of all types
Reports claims to the excess carrier when applicable
Communicates claim status with the customer and claimant
Adheres to client and carrier guidelines and participates in claims review as needed
Develops and maintains professional customer relationships
Complies with rules and regulations of applicable state
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 with the ability to utilize MS Office including Excel spreadsheets
Strong interpersonal, time management and organizational skills
Ability to work both independently and within a team environment
Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation
Bachelor's degree or a combination of education and related experience
Minimum of 6 years' industry experience and claim handling

Preferred

Self-Insured Certificate
State Certification as an experienced Examiner

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

Company

CorVel Corporation

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CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry.

Funding

Current Stage
Public Company
Total Funding
unknown
1991-07-05IPO

Leadership Team

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Jeff Gurtcheff
Chief Claims Officer
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Maxim Shishin
CIO
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Company data provided by crunchbase