Medical Only Claims Specialist

CorVel Corporation•Portland, OR

4d•$17 - $27•Remote

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 handles claims from initial receipt through compensability assessment, reserve establishment, payment authorization, and communication of claim status. The specialist follows client and carrier guidelines and may assist other claims professionals with complex or problematic claims.

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 required.
Licensed as required jurisdictionally.
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

Receives Workers’ Compensation claims, confirms policy coverage, and acknowledges the claim.
Determines the validity and compensability of claims.
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.
Performs additional duties as assigned.