Senior Claims Specialist

1 week ago


Jackson, Mississippi, United States CorVel Enterprise Comp, Inc. Full time
About This Role

We are seeking a skilled Senior Claims Specialist to join our team at CorVel Enterprise Comp, Inc.

Job Summary

This role involves managing complex and problematic workers' compensation claims within delegated authority limits. You will work closely with case managers and attorneys to determine benefits due, manage subrogation, and negotiate settlements to achieve the best possible outcome in the claim.

Key Responsibilities
  • Receives claims, confirms policy coverage, and acknowledges the claim
  • Determines validity and compensability of the claim by investigating and gathering information regarding the claim 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 overall cost of the claim
  • Coordinates early return-to-work efforts with the appropriate parties
  • Manages subrogation and litigation of claim as it applies
  • 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
Requirements
  • 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
  • Bachelor's degree or a combination of education and related experience
  • Minimum of 3 years' industry experience and claim handling
Benefits and Compensation

CorVel offers a comprehensive benefits package to its full-time regular employees, including 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.

The estimated salary for this role is between $56,860 and $91,580, based on location and experience.



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