CA WC Claims Specialist (SIP)

CorVel•Rancho Cucamonga, CA

64d•$25 - $40•Remote

About The Position

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote position. Candidate must hold a Self-Insurance Certification. Must reside in the state of California.

Requirements

Excellent written and verbal communication skills
Ability to learn rapidly 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 meet or exceed performance competencies
Ability to work both independently and within a team environment
Bachelor's degree or a combination of education and related experience
Minimum of 1 year of industry experience and claims management preferred
State Certification as an Experienced Examiner
Ed-Code Experience
Must have SIP Certification

Nice To Haves

Bilingual in English and Spanish preferred

Responsibilities

Receives claims, confirms policy coverage and acknowledgment of the claim
Determines validity and compensability of the claim
Establishes reserves and authorizes payments within reserving authority limits
Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program ("IIPP")
Additional duties as assigned