Senior Claims Specialist

🔥 3 minutes ago

🍁 Vermont – Remote

🍁 Vermont – Remote

💵 $61.1k - $98.3k / year

⏰ 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

• Handle complex and high-profile Workers’ Compensation claims following company standards • Work closely with case managers and attorneys • Receive Workers’ Compensation claims and confirm policy coverage and claim acknowledgement • Investigate claims, determine validity and compensability, and gather information • File necessary documentation with state agencies • Establish reserves and authorize payments within reserving authority limits • Develop and manage documented 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 • Perform additional duties as assigned

🎯 Requirements

• Vermont adjuster license required • Bachelor's degree or a combination of education and related experience • Minimum of 3 years’ industry experience and claim handling • Self-Insured Certificate preferred • State Certification or license as an experienced claims adjuster • Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel • 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, including 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 applicable to Workers’ Compensation

🏖️ 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 • 401K • ROTH 401K • Paid time off • Career advancement opportunities • Remote work arrangement