Senior Claims Specialist

2 days ago


Charlotte, North Carolina, United States CorVel Enterprise Comp, Inc. Full time

h3Job Description/h3pThe Senior Claims Specialist plays a crucial role in managing complex and problematic workers' compensation claims within company standards and best practices. This position involves determining benefits due, working closely with case managers and attorneys, and managing subrogation and negotiations to ensure specific customer service requirements are met./ppbKey Responsibilities:/b/pulliReceives and confirms claim information, including policy coverage and acknowledgement./liliDetermines the validity and compensability of claims by investigating and gathering necessary documentation./liliEstablishes reserves and authorizes payments within reserving authority limits./liliDevelops and manages well-documented action plans with case managers and outcomes managers to reduce overall claim costs./liliCoordinates early return-to-work efforts with relevant parties./liliManages subrogation and litigation of claims as applicable./liliReports claims to excess carriers when necessary./liliCommunicates claim status with customers and claimants./liliAdheres to client and carrier guidelines and participates in claims review as needed./liliDevelops and maintains professional customer relationships./liliComplies with applicable state regulations./li/ulpbRequirements:/b/pulliExcellent written and verbal communication skills./liliAbility to assist team members in developing knowledge and understanding of claims practice./liliAbility to identify, analyze, and solve problems./liliComputer proficiency and technical aptitude with the ability to utilize MS Office, including Excel spreadsheets./liliStrong interpersonal, time management, and organizational skills./liliAbility to work both independently and within a team environment./liliKnowledge of the entire claims administration, case management, and cost containment solution as applicable to workers' compensation./li/ulpbEducation/Experience:/b/pulliBachelor's degree or a combination of education and related experience./liliMinimum of 3 years' industry experience and claim handling./liliSelf-Insured Certificate preferred./liliState Certification as an experienced Examiner./li/ulpbPay Range:/b $58,282 – $93,870/ppA 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./ppCorVel is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable./p



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