Medical Only Claims Specialist

About the role

This remote position supports the goals of the Claims Department and of CorVel by managing non-complex and non-problematic, medical only workers’ compensation claims under close supervision.

Responsibilities

• Receive workers’ compensation claims and confirm policy coverage and acknowledgement of the claim
• Determine the validity and compensability of the claim
• Establish reserves and authorize payments within established reserving authority limits
• Communicate claim status with the customer, claimant and client
• Adhere to client and carrier guidelines and participate in claims review as needed
• Assist other claims professionals with more complex or problematic claims as necessary
• Perform additional duties as assigned

Knowledge & Skills

• 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

Education & Experience

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

Pay

Pay rates are established using a market-based approach and may vary by location. Factors include federal, state, and local minimum wage requirements, geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. New hires may be slotted into a different level based on assessment during the interview process, which may impact the salary range. Pay range: $16.74 – $26.92 per hour.

Benefits

• Medical (HDHP) with 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
• 401(k) and ROTH 401(k)
• Paid time off