Medical Only Claims Specialist
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 CorVel. This is a remote position. The role handles claims from receipt through coverage confirmation, compensability determination, reserving, payment authorization, and communications with customers, claimants, and clients. The specialist follows client and carrier guidelines, participates in claims reviews as needed, and assists other claims professionals with more complex or problematic claims. The position requires Workers’ Compensation experience, at least one year of industry experience and claim handling, and an AZ Adjuster license. A bachelor’s degree or a combination of education and related experience is required. Pay is listed at $16.74–$26.92 per hour, with rates varying based on factors including location, skills, and experience.
Requirements
- Bachelor’s degree or a combination of education and related experience.
- Minimum of 1 year of industry experience and claim handling.
- Workers’ Compensation experience required.
- AZ Adjuster license required.
- Excellent customer service skills.
- Excellent written and verbal communication skills.
- Ability to learn quickly and develop knowledge of claims practice, relevant statutes, and medical terminology.
- Ability to identify, analyze, and solve problems.
- Computer proficiency and technical aptitude to use Microsoft Office, including Excel spreadsheets.
- Strong interpersonal, time management, and organizational skills.
- Ability to work independently and within a team environment.
Responsibilities
- Receive Workers’ Compensation claims and confirm policy coverage and acknowledgement of the claim.
- Determine the validity and compensability of claims.
- Establish reserves and authorize payments within established reserving authority limits.
- Communicate claim status with the customer, claimant, and client.
- 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.
- Perform additional duties as assigned.
Benefits
- Medical (HDHP) with pharmacy
- Dental insurance
- Vision insurance
- Long-term disability insurance
- Health Savings Account
- Flexible Spending Account options
- Life insurance
- Accident insurance
- Critical illness insurance
- Pre-paid legal insurance
- Parking and Transit FSA accounts
- 401(k)
- Roth 401(k)
- Paid time off
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
