CA Medical Only Claims Specialist

5 months ago


Roseville, United States CorVel Corporation Full time

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.

This is a remote job opportunity.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Receives 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 projects and duties as assigned.

KNOWLEDGE & SKILLS:

Excellent Customer Service Skills. Excellent written and verbal communication skills. Ability to learn rapidly to develop knowledge and understanding of claims practice, relevant statutes and medical terminology. 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.

EDUCATION & EXPERIENCE:

Bachelor's degree or a combination of education and related experience. Minimum of 1 year industry experience and medical only claim handling. Licensed as required jurisdictionally.

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: $16.00 - $25.69 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.

#LI-Remote



  • Roseville, United States CorVel Corporation Full time

    The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote opportunity. ...


  • Roseville, United States PMA Companies Full time

    Account Claims Representative II - CA #4366 Multiple Locations Apply for this job now! Job Description: As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer...

  • Claims Associate

    1 week ago


    Roseville, United States PMA Companies Full time

    Back Account Claims Associate I -CA #4365 Multiple Locations + 2 more Apply Apply for this job now! Apply Job Description: In this position, you will investigate and maintain medical only and limited lost time workers‘ compensation claims. In this position you will determine liability, secure information and settles claims. Under close supervision...

  • Claims Specialist

    4 weeks ago


    Roseville, California, United States CorVel Enterprise Comp, Inc. Full time

    Job SummaryWe are seeking a highly skilled Claims Specialist to join our team at CorVel Enterprise Comp, Inc. The ideal candidate will have a strong background in workers' compensation claims management and excellent communication skills.Key Responsibilities:Manage workers' compensation claims from inception to closure, ensuring timely and accurate...


  • Roseville, United States TheBest Claims Solutions Full time

    Our client, is in need of a Temporary Workers' Compensation Claims Adjuster to work in their Roseville, CA office. The ideal candidate will have 2+ years of California Workers Compensation Experience.Required Qualifications:2+ years of experience handling CA Workers Compensation claims from inception to close.Ability to manage multiple tasks efficiently and...


  • Roseville, United States TheBest Claims Solutions Full time $45 - $50

    Our client, is in need of a Temporary Workers' Compensation Claims Adjuster to work in their Roseville, CA office. The ideal candidate will have 2+ years of California Workers Compensation Experience.The experience expected from applicants, as well as additional skills and qualifications needed for this job are listed below.Required Qualifications:2+ years...


  • Roseville, United States PMA Companies Full time

    Back Account Claims Representative II - CA #4366 Multiple Locations + 4 more Apply Apply for this job now! Apply Job Description: As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In...


  • Roseville, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...


  • Roseville, United States Gainwell Technologies Full time

    About the RoleGainwell Technologies is seeking a skilled Dental Claims Specialist to join our team. As a key member of our operations team, you will play a critical role in ensuring the smooth processing of dental claims and treatment authorization requests.Key ResponsibilitiesReview and approve treatment authorization requests (TARs) to ensure compliance...


  • Roseville, United States Techlink Systems Inc Full time

    Job Title: Claims Examiner - Workers Compensation Location (On-site, Remote, or Hybrid?): Roseville, CA (remote) Contract Duration: Contract until 12/28/2024 REQUIREMENTS: Any license/ certification: CA licensed Years of experience: 4 or more years of relevant WC claims handling experience PRIMARY PURPOSE: To analyze complex or...


  • Roseville, California, United States Sedgwick Full time

    Job SummaryWe are seeking a highly skilled Workers Compensation Claims Examiner to join our team at Sedgwick. As a key member of our claims team, you will be responsible for analyzing and processing complex workers' compensation claims, ensuring timely and accurate resolution of claims, and providing exceptional customer service to our clients.Key...


  • Roseville, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your...


  • Roseville, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your...


  • Roseville, California, United States AutoNation Full time

    Service Warranty Administrator Job DescriptionAutoNation is one of the largest automotive retailers in the United States, offering innovative products, exceptional services, and comprehensive solutions, empowering our customers to make the best decisions for their needs.As a Service Warranty Administrator, you will play a critical role in reviewing and...


  • Roseville, California, United States Sedgwick Full time

    Job SummarySedgwick is seeking a skilled Workers Compensation Claims Examiner to join our team. As a Claims Examiner, you will be responsible for analyzing complex workers' compensation claims to determine benefits due. Your expertise will be essential in managing claims through well-developed action plans to achieve timely and cost-effective resolutions.Key...

  • Claims Supervisor

    4 days ago


    Roseville, United States PMA Companies Full time

    Back Regional Claims Supervisor - Workers Compensation - Remote #3938 Multiple Locations + 2 more Apply Apply for this job now! Apply Job Description: As a member of our Claims management team supervise claims staff to ensure appropriate claim outcomes through consistent execution of best claims practice. In this role utilize your prior claims and...


  • Roseville, California, United States The Permanente Medical Group, Inc. - Nrnia Full time

    OB/GYN Physician OpportunityThe Permanente Medical Group, Inc. is seeking a full-time OB/GYN physician to join our team in Sacramento, CA. Our community offers a great balance of outdoor activities, urban amenities, and a relaxed pace of life. With highly rated public-school systems and a strong sense of community, there's something for everyone.As a member...


  • Roseville, California, United States PMA Companies Full time

    The Claims Apprentice Program at PMA Companies is a nine-month training opportunity for recent college graduates interested in a career as a Claims Adjuster in the Property & Casualty insurance industry.As a Claims Apprentice, you will be trained by PMA's team of claims experts and leaders, developing your skills and knowledge in workers' compensation and/or...


  • Roseville, United States Roberts & Son Black Oxide Specialist Full time

    Job SummaryWe are seeking a highly organized and self-motivated General Laborer to join our team at Roberts & Son Black Oxide Specialist Inc.ResponsibilitiesRack and unrack steel parts with precision and efficiency.Ensure smooth shipping and receiving processes.Operate Hi-Lo equipment with confidence.Possess electrical and plumbing knowledge, with a plus for...

  • Litigation Specialist

    1 month ago


    Roseville, California, United States PMA Companies Full time

    Job Title: Litigation SpecialistAt PMA Companies, we are seeking a highly skilled Litigation Specialist to join our team. As a key member of our claims team, you will be responsible for investigating, evaluating, and resolving complex and litigated Automobile, General Liability, and Property claims for our large self-insured clients.Key...