Workers' Compensation Claims Specialist

4 weeks ago


Franklin, Tennessee, United States CorVel Enterprise Comp, Inc. Full time
Job Description

The Claims Specialist plays a crucial role in managing workers' compensation claims within CorVel Enterprise Comp, Inc. The ideal candidate will have a strong understanding of claims practices and be able to identify, analyze, and solve problems effectively.

This is a work-from-home position, reporting to our Franklin, TN office. The successful candidate will be responsible for:

  • Receiving claims, confirming policy coverage, and acknowledging the claim.
  • Determining the validity and compensability of the claim.
  • Establishing reserves and authorizing payments within reserving authority limits.
  • Managing non-complex and non-problematic medical-only claims and minor lost-time workers' compensation claims under close supervision.
  • Communicating claim status with the customer, claimant, and client.
  • Adhering to client and carrier guidelines and participating in claims review as needed.
  • Assisting other claims professionals with more complex or problematic claims as necessary.
  • Requires regular and consistent attendance.
  • Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (IIPP).
  • Additional projects and duties as assigned.

The successful candidate will possess:

  • Excellent written and verbal communication skills.
  • Ability to learn rapidly 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 meet or exceed performance competencies.
  • Ability to work both independently and within a team environment.

CorVel Enterprise Comp, Inc. offers a comprehensive benefits package, including medical, 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, 401(k), ROTH 401(k), and paid time off.

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



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