CA WC Claims Specialist

CorVel Corporation•Rancho Cucamonga, CA

3d•$25 - $41•Remote

About The Position

The CA Workers’ Compensation Claims Specialist manages lower-level, non-complex, and 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 specialist receives and evaluates workers’ compensation claims, manages non-complex lost-time claims under close supervision, establishes reserves and authorizes payments within authority limits, and communicates claim status to customers, claimants, and clients. The role also follows client and carrier guidelines, participates in claims reviews as needed, and assists other claims professionals with complex or problematic claims. CorVel is a national provider of risk management solutions for workers’ compensation, auto, health, and disability management. The company was founded in 1987 and has been publicly traded on NASDAQ since 1991. It reports having more than 4,000 employees across the United States and describes its culture as supportive, with career advancement opportunities.

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 license or certification in Workers’ Compensation, maintained throughout employment with CorVel.

Nice To Haves

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

Responsibilities

Receive workers’ compensation claims, confirm policy coverage, and acknowledge claims.
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 to 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.