Medical Only Claims Specialist

CorVel Corporation•Santa Fe, NM

8h•Remote

About The Position

The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel. This is a remote role; candidates must reside in New Mexico and have an active adjuster license in the state.

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
Workers’ Compensation experience required
Licensed as required jurisdictionally
Must have an active adjuster license in the state

Responsibilities

Receives Workers’ Compensation 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