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Senior Claims Specialist
CorVel Corporation. Handle complex and high-profile Workers’ Compensation claims according to company standards .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing complex Workers’ Compensation claims, including investigation, documentation, and compliance with state regulations. Proficient in developing action plans and maintaining professional relationships to optimize claim outcomes.
Highest-signal resume keywords
Workers’ Compensation Claims ManagementClaims Investigation and DocumentationState Certification as Claims AdjusterCost Containment SolutionsCustomer Relationship Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AdministrationCase ManagementProblem Identification and AnalysisReserve EstablishmentPayment Authorization
Soft Skills
Excellent Written CommunicationExcellent Verbal CommunicationTime ManagementOrganizational SkillsInterpersonal Skills
Tools & Technologies
Microsoft OfficeExcel Spreadsheets
Certifications & Qualifications
Self-Insured CertificateWorkers’ Compensation License
Industry Keywords
Claims HandlingSubrogationLitigation ManagementCalifornia State RegulationsInjury and Illness Prevention Program
About the role
Key responsibilities & impact- Handle complex and high-profile Workers’ Compensation claims according to company standards
- Receive claims and confirm policy coverage and claim acknowledgement
- Investigate claims, determine validity and compensability, and file necessary documentation with state agencies
- Establish reserves and authorize payments within reserving authority limits
- Develop and manage documented action plans with case managers and outcomes managers to reduce claim costs
- Coordinate early return-to-work efforts
- Manage claim subrogation and litigation
- Manage potential claim recoveries
- Report claims to excess carriers when applicable
- Communicate claim status with customers and claimants
- Adhere to client and carrier guidelines and participate in claims reviews
- Develop and maintain professional customer relationships
- Comply with applicable state rules, regulations, safety rules and the Injury and Illness Prevention Program
- Support Claims Department and CorVel goals; perform additional duties as assigned
Requirements
What you’ll need- Bachelor's degree or a combination of education and related experience
- Minimum of 3 years’ industry experience and claim handling
- Self-Insured Certificate preferred
- State Certification or license as an experienced claims adjuster
- Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel
- Excellent written and verbal communication skills
- Ability to identify, analyze and solve problems
- Computer proficiency and technical aptitude, including Microsoft Office and Excel spreadsheets
- Strong interpersonal, time management and organizational skills
- Ability to work independently and within a team environment
- Knowledge of claims administration, case management and cost containment solutions applicable to Workers’ Compensation
- Must reside in California
Benefits
Comp & perks- Medical (HDHP) with Pharmacy
- Dental insurance
- Vision insurance
- 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
- Paid time off
- Career advancement opportunities
- Supportive company culture