Senior Claims Specialist

5 days ago


Rancho Cucamonga, California, United States CorVel Corporation Full time
Job Title: Senior Claims Specialist

CorVel Corporation is seeking a highly skilled Senior Claims Specialist to join our team. As a Senior Claims Specialist, you will be responsible for managing complex and problematic workers' compensation claims within delegated limited authority to determine benefits due.

Key Responsibilities:
  • Investigate and gather information regarding claims and file necessary documentation with state agencies.
  • Determine validity and compensability of claims.
  • Establish reserves and authorize payments within reserving authority limits.
  • Develop and manage well-documented action plans with case managers and outcomes managers to reduce overall claim costs.
  • Coordinate early return-to-work efforts with appropriate parties.
  • Manage subrogation and litigation of claims as applicable.
  • Manage potential claim recoveries of all types.
  • Report claims to excess carriers when applicable.
  • Communicate claim status with customers and claimants.
  • Adhere to client and carrier guidelines and participate in claims review as needed.
  • Develop and maintain professional customer relationships.
  • Comply with rules and regulations of applicable states.
Requirements:
  • Bachelor's degree or combination of education and related experience.
  • Minimum of 3 years' industry experience and claim handling.
  • Self-Insured Certificate preferred.
  • State Certification as an experienced Examiner.
  • SIP Certification required.
  • Bilingual in English & Spanish required.
What We Offer:

CorVel Corporation 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, 401(k), ROTH 401(k), and paid time off.

CorVel Corporation is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable.



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