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Workers Compensation Claims Specialist

1 month ago

Glen Allen, Virginia, United States CorVel Corporation Full time
Job Summary

CorVel is seeking a skilled Workers Compensation Claims Specialist to join our team. As a key member of our claims team, you will be responsible for analyzing and managing complex workers' compensation claims. Your expertise will be essential in reviewing, investigating, and making decisions regarding coverage, compensability, and appropriateness of claims.

Key Responsibilities
  • Analyze and process workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
  • Negotiate settlement of claims up to designated authority level and make claims payments.
  • Process complex or technically difficult claims.
  • Calculate and assign timely and appropriate reserves to claims and continue to manage reserve adequacy throughout the life of the claim.
  • Calculate and pay benefits due; approve all claim payments; and settle claims within designated authority level.
  • Develop and manage claims through well-developed action plans; continue to work the action plan to bring the claim to an appropriate and timely resolution.
  • Prepare necessary state filings within statutory limits.
  • Actively manage the litigation process; ensure timely and cost-effective claims resolution.
  • Coordinate vendor referrals for additional investigation and/or litigation management.
  • Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
  • Manage claim recoveries of all types.
  • Report claims to the excess carrier, respond to requests of directions in a professional and timely manner.
  • Frequently communicate with all appropriate parties involved with the claim.
  • Refer cases as appropriate to management.
  • Maintain professional client relationships.
  • Actively execute appropriate claims activities to ensure consistent delivery of quality claims service.
Requirements
  • 3+ years of Workers Compensation claims management experience.
  • In-depth knowledge of appropriate insurance principles and laws for workers' compensation.
  • Exceptional customer service skills.
  • Strong written and verbal communication skills.
  • Strong organizational skills.
  • Strong negotiation skills.
  • Strong analytical and interpretive skills.
  • PC literate.
  • Baccalaureate degree from an accredited college or university preferred.
  • Professional certification as applicable to workers' compensation required.