Claims Specialist Professional
3 weeks ago
CorVel Enterprise Comp, Inc. is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. 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. We value Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT).
Job Summary:
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 hybrid position that requires excellent customer service skills, written and verbal communication skills, ability to learn rapidly to develop knowledge and understanding of claims practice, relevant statutes and medical terminology, problem-solving skills, computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets, strong interpersonal, time management and organizational skills, and ability to work both independently and within a team environment.
Key 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
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
Salary Information:
The estimated salary for this role is between $15.98 and $25.69 per hour.
Benefits:
- Comprehensive benefits package 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.
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