Medical Only Claims Specialist
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 position is open to remote or hybrid. ESSENTIAL FUNCTIONS & 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
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
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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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
