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CA Senior Claims Specialist

United States · remote · Salary not listed

Role overview

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

ReceivesWorkers’ Compensation claim, confirms policy coverage and acknowledgement of the claim
Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies
Establishes reserves and authorizes payments within reserving authority limits
Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim
Coordinates early return-to-work efforts with the appropriate parties
Manages subrogation and litigation of claim as it applies
Manages potential claim recoveries of all types
Reports claims to the excess carrier when applicable
Communicates claim status with the customer and claimant
Adheres to client and carrier guidelines and participates in claims review as needed
Develops and maintains professional customer relationships
Complies with rules and regulations of applicable state
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)
Additional duties as assigned

KNOWLEDGE & SKILLS:

Excellent written and verbal communication skills
Ability to assist team members to develop knowledge and understanding of claims practice
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
Strong interpersonal, time management and organizational skills
Ability to work both independently and within a team environment
Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation

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CA Senior Claims Specialist

Role overview

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

KNOWLEDGE & SKILLS:

EDUCATION & EXPERIENCE:

PAY RANGE

Pay Range: $29.35.81 - $47.28 per hour

ABOUT CORVEL: