CA Senior WC Claims Specialist

The WC 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 is a remote position. Essential Functions & Responsibilities Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the appropriate parties Manages subrogation and litigation of claim as it applies Manages potential claim recoveries of all types Reports claims to the excess carrier when applicable Communicates claim status with the customer and claimant Adheres to client and carrier guidelines and participates in claims review as needed Develops and maintains professional customer relationships Complies with rules and regulations of applicable state Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (IIPP) Additional duties as assigned Knowledge & Skills 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 Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation Education & Experience 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 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. Pay Range: $29.35 - $47.28 per hour. A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management. Equal Opportunity Employment CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #J-18808-Ljbffr CorVel Corporation