Medical Only Claims Specialist

About the role

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel. This is a remote role.

Responsibilities

• Receives claims, confirms policy coverage and acknowledges the claim
• Determines the validity and compensability of the claim
• Establishes reserves and authorizes payments within established reserving authority limits
• Communicates claim status with the customer, claimant and client
• Adheres to client and carrier guidelines and participates in claims review as needed
• Affords assistance to other claims professionals with more complex or problematic claims as necessary

Requirements

• Excellent customer service skills
• Excellent written and verbal communication skills
• Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
• Ability to identify, analyze and solve problems
• Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
• Strong interpersonal, time management, and organizational skills
• Ability to work both independently and within a team environment

Qualifications

• Bachelor's degree or a combination of education and related experience
• Minimum of 1 year industry experience and claim handling WC experience required
• Licensed as required jurisdictionally

Skills

• Customer service skills
• Written and verbal communication skills
• Problem solving skills
• Computer proficiency
• Interpersonal, time management, and organizational skills

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

Pay

CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Schedule

This is a remote role.