Senior Claims Specialist, SIP

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $29 - $47 / hour

⏰ Full Time

🟠 Senior

📋 Claims Specialist

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CorVel Corporation

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1987

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

CorVel Corporation is a risk management and healthcare services company that provides integrated claims and care solutions for payors and employers. It specializes in workers' compensation, liability and disability management, provider and pharmacy networks, and alternative risk solutions, and it offers technology platforms that use AI and data analytics to streamline claims administration, improve outcomes, and reduce costs.

📋 Description

• Manage complex and problematic, high-visibility workers’ compensation claims within delegated limited authority • Determine benefits due and claim validity/compensability through investigation and information gathering • Confirm policy coverage and acknowledge claims • File necessary claim documentation with state agencies • Establish reserves and authorize payments within authority limits • Develop and manage action plans with case managers and outcomes managers to reduce claim costs • Coordinate early return-to-work efforts • Manage subrogation, litigation, and potential claim recoveries • Report claims to excess carriers when applicable • Communicate claim status with customers and claimants • Adhere to client and carrier guidelines and participate in claims reviews • Develop and maintain professional customer relationships • Comply with applicable state rules and regulations • Work closely with case managers and attorneys and negotiate settlements

🎯 Requirements

• Bachelor's degree or a combination of education and related experience • 4–5 years of California Workers’ Compensation claims handling experience required • California workers compensation adjuster license required • 4850 experience required • Associates in Claims or Associates in Risk Management designation preferred • Excellent written and verbal communication skills • Ability to assist team members in developing claims-practice knowledge • Ability to identify, analyze, and solve problems • Computer proficiency and technical aptitude, including MS 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 applicable to Workers’ Compensation

🏖️ Benefits

• Medical (HDHP) w/Pharmacy • Dental • Vision • 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 • 401K • ROTH 401K • Paid time off • Career advancement opportunities • Supportive culture