WC Claims Specialist
About The Position
The Workers’ Compensation Claims Specialist manages lower-level, non-complex, and non-problematic workers’ compensation claims within delegated limited authority, following company best practices and under the direct supervision of a senior claims professional. The role supports the goals of the claims department and CorVel and is remote. The specialist receives workers’ compensation claims, confirms policy coverage and claim acknowledgment, determines claim validity and compensability, establishes reserves, and authorizes payments within authority limits. The role manages non-complex lost-time claims under close supervision, communicates claim status with customers, claimants, and clients, follows client and carrier guidelines, participates in claims reviews as needed, and may assist with more complex or problematic claims.
Requirements
- Bachelor’s degree or a combination of education and related experience.
- Excellent written and verbal communication skills.
- Ability to learn rapidly and develop knowledge and understanding of claims practice.
- Ability to identify, analyze, and solve problems.
- Computer proficiency and technical aptitude, including ability to use Microsoft Office and Excel spreadsheets.
- Strong interpersonal, time management, and organizational skills.
- Ability to meet or exceed performance competencies.
- Ability to work independently and within a team environment.
- Maintain a current Workers’ Compensation license or certification throughout employment.
Nice To Haves
- Minimum of 1 year of industry experience and claims management preferred.
Responsibilities
- Receive workers’ compensation claims and confirm policy coverage and acknowledgment of the claim.
- Determine the validity and compensability of claims.
- Establish reserves and authorize payments within reserving authority limits.
- Manage non-complex lost-time workers’ compensation claims under close supervision.
- Communicate claim status with the customer, claimant, and client.
- 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 projects and duties as assigned.
Benefits
- Medical (HDHP) with pharmacy
- Dental insurance
- Vision insurance
- Long-term disability
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
