Medical Only Claims Specialist

CorVel Corporation•Phoenix, AZ

7d•$17 - $27•Remote

About The Position

The Medical Only Claims Specialist manages non-complex and non-problematic workers’ compensation medical-only claims under close supervision, supporting the goals of the Claims Department and CorVel. This is a remote position. The role receives and evaluates claims, establishes reserves and authorizes payments within delegated limits, and communicates claim status to customers, claimants, and clients. The specialist follows client and carrier guidelines and assists other claims professionals with more complex or problematic claims as needed.

Requirements

Bachelor's degree or a combination of education and related experience.
At least 1 year of industry experience and claim handling.
Workers’ compensation experience.
Arizona Adjuster license.
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, including use of Microsoft Office and Excel spreadsheets.
Strong interpersonal, time management, and organizational skills.
Ability to work independently and within a team environment.

Responsibilities

Receive workers’ compensation claims, confirm policy coverage, and acknowledge 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 review as needed.
Assist other claims professionals with more complex or problematic claims as necessary.
Perform additional duties as assigned.