Senior Claims Specialist

Senior Claims Specialist

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This role is available for both remote and hybrid work arrangements.

Essential functions and responsibilities include receiving Workers' Compensation claims, confirming policy coverage and acknowledgement of the claim; determining validity and compensability of the claim by investigating and gathering information regarding the claim and filing necessary documentation with state agencies; establishing reserves and authorizing payments within reserving authority limits; developing and managing well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim; coordinating early return-to-work efforts with the appropriate parties; managing subrogation and litigation of claim as it applies; managing potential claim recoveries of all types; reporting claims to the excess carrier when applicable; communicating claim status with the customer and claimant; adhering to client and carrier guidelines and participating in claims review as needed; developing and maintaining professional customer relationships; complying with rules and regulations of applicable state; and additional duties as assigned.

Knowledge and skills include 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 with the ability to utilize Microsoft Office including Excel spreadsheets; strong interpersonal, time management and organizational skills; ability to work both independently and within a team environment; and knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation.

Education and experience include a 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.

Pay range: $61,053 – $98,334. 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.

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. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes 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, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.