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Claims Specialist

1 month ago

Rancho Cucamonga, California, United States CorVel Corporation Full time
Job Summary

The Claims Specialist is responsible for managing workers' compensation claims within delegated authority to achieve the best possible outcome. This role supports the goals of the claims department and CorVel Corporation.

Key Responsibilities
  • Receive and confirm claims, verifying policy coverage and acknowledging the claimant.
  • Determine the validity and compensability of claims, establishing reserves and authorizing payments within reserving authority limits.
  • Manage non-complex and non-problematic medical-only claims and minor lost-time workers' compensation claims under close supervision.
  • Communicate claim status with customers, claimants, and clients, adhering to client and carrier guidelines.
  • Assist other claims professionals with more complex or problematic claims as necessary.
  • Ensure regular and consistent attendance, complying with all safety rules and regulations during working hours.
Requirements
  • Excellent written and verbal communication skills.
  • Ability to learn rapidly and 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.
Education and Experience
  • Bachelor's degree or a combination of education and related experience.
  • Minimum of 1 year of industry experience and claims management preferred.
  • State Certification as an Experienced Examiner.

CorVel Corporation is an Equal Opportunity Employer and complies with ADA regulations as applicable. #LI-Remote