Medical Only Claims Specialist

CorVel Career Site•Greenwood Village, CO

6d•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 receives Workers’ Compensation claims, confirms coverage and claim acknowledgement, determines claim validity and compensability, establishes reserves, and authorizes payments within established limits. The specialist communicates claim status to customers, claimants, and clients; 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 strong customer service, communication, problem-solving, organizational, and interpersonal skills, along with computer proficiency and the ability to learn claims practices, relevant statutes, and medical terminology. A bachelor’s degree or a combination of education and related experience is required, as is at least one year of industry experience and claim handling experience. Workers’ Compensation experience and an Arizona Adjuster license are required. The pay range is $16.74–$26.92 per hour. CorVel states that pay may vary by location and other factors. A comprehensive benefits package is available to full-time regular employees.

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.
Arizona Adjuster license required.
Excellent customer service skills.
Excellent written and verbal communication skills.
Ability to learn quickly and develop knowledge of 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 claim acknowledgement.
Determine the validity and compensability of claims.
Establish reserves and authorize payments within established reserving authority limits.
Communicate claim status with customers, claimants, and clients.
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.