Medical Only Claims Specialist

About the role

Manages non-complex and non-problematic, medical only workers’ compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel. This role is available for both remote and hybrid work arrangements.

Responsibilities

• Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of 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
• Assists other claims professionals with more complex or problematic claims as necessary
• Additional duties as assigned

Requirements

• 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

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

Pay

CorVel uses a market-based approach to pay. Pay rates are established taking into account federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Pay range: $16.74 - $26.92 per hour.

Benefits

A comprehensive benefits package is available for full-time regular employees and includes:

• 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
• 401K and ROTH 401K
• Paid time off

About CorVel

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. Founded in 1987 and publicly traded on the NASDAQ stock exchange since 1991, CorVel continually invests in human capital and technology to deliver innovative and integrated solutions. The company has over 4,000 employees across the United States and embraces core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT!).