Medical Only Claims Specialist SIP - Bilingual

CorVel Career SiteRancho Cucamonga, CA
15h$17 - $26Remote

About The Position

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel. This is a remote position.

Requirements

  • Excellent customer service skills
  • Excellent written and verbal communication skills
  • Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
  • Ability to identify, analyze and solve problems
  • Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
  • Strong interpersonal, time management, and organizational skills
  • 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 industry experience and claim handling WC experience required
  • Licensed as required jurisdictionally
  • Bilingual in English and Spanish

Responsibilities

  • Receives claims, confirms policy coverage and acknowledgement of the claim
  • Determines the validity and compensability of the claim
  • Establishes reserves and authorizes payments within established reserving authority limits
  • 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
  • Additional duties as assigned

Benefits

  • 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
  • paid time off
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