Senior New York Claims Specialist

CorVel Career Site•Syracuse, NY

6d•Remote

About The Position

The Senior Claims Specialist handles complex and high-profile Workers’ Compensation claims in accordance with company standards. The role works closely with case managers and attorneys, manages subrogation, and negotiates settlements to help achieve favorable claim outcomes, meet customer service expectations, and support the goals of the Claims Department and CorVel. This is a remote role. A New York state independent adjuster license is required.

Requirements

New York state independent adjuster license required.
Bachelor’s degree or a combination of education and related experience.
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.
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 the ability to use Microsoft Office and Excel spreadsheets.
Strong interpersonal, time-management, and organizational skills.
Ability to work independently and within a team environment.
Knowledge of claims administration, case management, and cost-containment solutions as applicable to Workers’ Compensation.

Nice To Haves

Self-Insured Certificate preferred.

Responsibilities

Receive Workers’ Compensation claims, confirm policy coverage, and acknowledge claims.
Investigate claims, determine validity and compensability, gather 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 costs.
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 with 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.
Perform additional duties as assigned.