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CorVel Corporation · 1 day ago

CA WC Senior Claims Specialist SIP

United States

Full-time

Remote

Mid, Senior Level

$28.69/hr - $46.21/hr

4+ years exp

CorVel Corporation is a national provider of industry-leading risk management solutions for various industries. They are seeking a Senior Claims Specialist to manage complex workers' compensation claims, ensuring compliance with company standards while collaborating with case managers and attorneys to achieve optimal claim outcomes.

InsuranceSoftware

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 projects and duties as assigned

Qualification

California Workers’ Compensation claimsCA workers compensation adjuster licenseClaims administration knowledgeMS Office proficiencyProblem-solving abilityCommunication skillsInterpersonal skillsTime management skillsOrganizational skillsTeamwork ability