CA Claims Specialist

CorVel Corporation•Folsom, CA

8d•$25 - $41•Remote

About The Position

The Workers’ Compensation Claims Specialist manages lower-level, non-complex, non-problematic workers’ compensation claims within delegated limited authority and company best practices. The role works under the direct supervision of a senior claims professional and supports the goals of the claims department and CorVel. This is a remote position. The position receives workers’ compensation claims, reviews coverage and compensability, sets reserves, authorizes payments within limits, and manages non-complex lost-time claims under close supervision. The specialist communicates claim status with customers, claimants, and clients, follows client and carrier guidelines, and supports colleagues on more complex claims as needed. CorVel is a national provider of risk management solutions for workers’ compensation, auto, health, and disability management. It was founded in 1987 and has more than 4,000 employees across the United States. The company describes its culture through the values Accountability, Commitment, Excellence, Integrity, and Teamwork.

Requirements

Excellent written and verbal communication skills.
Ability to learn rapidly and develop knowledge and understanding of claims practice.
Ability to identify, analyze, and solve problems.
Computer proficiency and technical aptitude, including the ability to use Microsoft Office and Excel spreadsheets.
Strong interpersonal, time-management, and organizational skills.
Ability to meet or exceed performance competencies.
Ability to work independently and within a team environment.
Bachelor’s degree or a combination of education and related experience.
Current Workers’ Compensation license or certification, which must be maintained throughout employment.

Nice To Haves

Minimum of 1 year of industry experience and claims management is preferred.

Responsibilities

Receive Workers’ Compensation claims, confirm policy coverage, and acknowledge the claim.
Determine claim validity and compensability.
Establish reserves and authorize payments within reserving authority limits.
Manage non-complex lost-time Workers’ Compensation claims under close supervision.
Communicate claim status with customers, claimants, and clients.
Adhere to client and carrier guidelines and participate in claims reviews as needed.
Assist other claims professionals with more complex or problematic claims as necessary.
Comply with safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (IIPP).
Perform additional projects and duties as assigned.