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Florida Workers' Compensation Claims Specialist
1 month ago
The Claims Specialist manages complex and problematic workers' compensation claims within delegated limited authority to determine benefits due. This role requires close collaboration with case managers and attorneys to manage subrogation and negotiate settlements to achieve the best possible outcome in the claim, supporting the goals of the claims department and CorVel.
Key Responsibilities- Receives and confirms claim, policy coverage, and acknowledgement of the claim.
- Determines validity and compensability of the claim by investigating and gathering information and filing necessary documentation with state agencies.
- Establishes reserves and authorizes payments within reserving authority limits.
- Develops and manages well-documented action plans with the case manager and outcomes manager to reduce the overall cost of the claim.
- Coordinates early return-to-work efforts with the appropriate parties.
- Manages subrogation and litigation of the claim as it applies.
- Manages potential claim recoveries of all types.
- Reports claims to the excess carrier when applicable.
- Communicates claim status with the customer and claimant.
- Adheres to client and carrier guidelines and participates in claims review as needed.
- Develops and maintains professional customer relationships.
- Complies with rules and regulations of applicable state.
- Additional projects and duties as assigned.
- Excellent written and verbal communication skills.
- Ability to assist team members to 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 work both independently and within a team environment.
- Knowledge of the entire claims administration, case management, and cost containment solution as applicable to Workers' Compensation.
- Bachelor's degree or a combination of education and related experience.
- 5+ years of experience handling Florida Workers Compensation claims.
- 6+ years of experience adjusting Florida lost time and litigated claims.
- Florida workers compensation adjuster license required.
- Municipality experience preferred but not necessary.
- Bilingual (Spanish and English) preferred.
CorVel offers a comprehensive benefits package including medical, 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.
About CorVelCorVel is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health, and disability management industries. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.
