Medical Claims Specialist

1 month ago


Downers Grove, Illinois, United States CorVel Enterprise Comp, Inc. Full time
Job Summary

We are seeking a highly skilled Medical Claims Specialist to join our team at CorVel Enterprise Comp, Inc. This role will involve managing non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision.

The ideal candidate will have excellent customer service skills, strong written and verbal communication skills, and the ability to learn rapidly to develop knowledge and understanding of claims practice, relevant statutes, and medical terminology.

Key Responsibilities:

  • Receives claims, confirms policy coverage, and acknowledges 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

Requirements:

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

What We Offer:

  • A comprehensive benefits package, including medical, dental, vision, and 401(k) plans
  • A stable and growing company with a strong, supportive culture and plenty of career advancement opportunities
  • A competitive salary range of $25.69 per hour

About CorVel:

CorVel Enterprise Comp, Inc. is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health, and disability management industries. We are a certified Great Place to Work Company and are committed to delivering the most innovative and integrated solutions to our clients.



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