Medical Only Claims Specialist
About The Position
The Workers’ Compensation Medical Only Claims Specialist manages non-complex, non-problematic medical-only claims under close supervision, supporting the goals of the Claims Department and CorVel. This is a remote position. The role receives Workers’ Compensation claims, confirms policy coverage and claim acknowledgement, determines claim validity and compensability, establishes reserves, and authorizes payments within established authority limits. The specialist communicates claim status with customers, claimants, and clients, follows client and carrier guidelines, and participates in claims reviews as needed. The position also assists other claims professionals with more complex or problematic claims as necessary and performs additional duties as assigned. The role requires customer service and communication skills, the ability to learn claims practices, relevant statutes, and medical terminology, problem-solving skills, and proficiency with Microsoft Office, including Excel. Candidates need a bachelor’s degree or a combination of education and related experience, at least one year of industry experience and claim handling, Workers’ Compensation experience, and licenses where required jurisdictionally. The stated pay range is $16.74–$26.92 per hour. Pay may vary based on location and job-related factors. CorVel offers a comprehensive benefits package to full-time regular employees. The position is remote.
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.
- Licensed as required jurisdictionally.
- Excellent customer service skills.
- Excellent written and verbal communication skills.
- Ability to learn claims practices, 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 claim validity and compensability.
- 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
