CA Senior Claims Specialist

CorVel Corporation • Folsom, CA

2d • $29 - $47 • Remote

About The Position

The Workers’ Compensation Senior Claims Specialist handles complex and high-profile claims in accordance with company standards. The role works closely with case managers and attorneys, manages subrogation, and negotiates settlements to achieve the best possible claim outcomes while meeting customer service expectations and supporting the goals of the Claims Department and CorVel. This is a remote position.

Requirements

• Minimum of 3 years of industry experience and claim handling.
• State certification or license as an experienced claims adjuster.
• Maintain a current Workers’ Compensation license or certification throughout employment with CorVel.
• Excellent written and verbal communication skills.
• Ability to assist team members in developing knowledge and understanding of claims practice.
• 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.
• Knowledge of Workers’ Compensation claims administration, case management, and cost containment solutions.
• Bachelor’s degree or a combination of education and related experience.

Nice To Haves

• Self-Insured Certificate preferred.

Responsibilities

• Receive Workers’ Compensation claims, confirm policy coverage, and acknowledge claims.
• Determine claim validity and compensability by investigating and gathering information, and file necessary documentation with state agencies.
• Establish reserves and authorize payments within reserving authority limits.
• Develop and manage documented action plans with the case manager and outcomes manager to reduce overall claim cost.
• Coordinate early return-to-work efforts with appropriate parties.
• Manage subrogation and litigation as applicable to the claim.
• Manage potential claim recoveries of all types.
• Report claims to the excess carrier when applicable.
• Communicate claim status to customers and claimants.
• Adhere to client and carrier guidelines and participate in claims reviews as needed.
• Develop and maintain professional customer relationships.
• Comply with applicable state rules and regulations.
• Comply with safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (IIPP).
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior