Senior Claims Specialist (SIP) 4850

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Job description

We are seeking a 4850 Sr. Claims Specialist for our Southern California Team. The Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.

We are open to remote work. Candidates must reside in California.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Receives 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

Additional projects and 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 MS 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

4-5 years of California Workers' Compensation claims handling experience required

CA workers compensation adjuster license required

Associates in Claims or Associates in Risk Management designation preferred

4850 experience required

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.

Pay Range: $27.34 - $44.03 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers Opportunities in Risk Management

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. 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.

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