CA Senior WC Claims Specialist

CorVel Corporation • Rancho Cucamonga, CA

2d • $29 - $47 • Remote

About The Position

The WC Senior Claims Specialist handles complex and high-profile Workers'
Compensation claims following company standards. This role works closely with
case managers and attorneys, manages subrogation, and negotiates
settlements. The Senior Claims Specialist ensures the best possible outcome for
the claim, meeting customer service expectations, and supporting the goals of
the Claims Department and CorVel.

This is a remote position.

Requirements

• 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 Microsoft 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 3 years’ industry experience and claim handling
• State Certification or license as an experienced claims adjuster
• Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel

Nice To Haves

• Self-Insured Certificate preferred

Responsibilities

• Receives Workers’ Compensation 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
• Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)
• Additional duties as assigned

Benefits

• A comprehensive benefits package is available for full-time regular employees and includes 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, and paid time off.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Number of Employees: 501-1,000 employees