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Senior Claims Specialist
CorVel Corporation. Handle complex and high-profile Workers' Compensation claims following 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 AdjusterCustomer Relationship ManagementProblem Identification and Analysis
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 HandlingPolicy Coverage ConfirmationReserve EstablishmentSubrogation ManagementLitigation ManagementCost Containment SolutionsClaims Administration KnowledgeTechnical AptitudeMicrosoft Office ProficiencyExcel Spreadsheet Skills
Soft Skills
Excellent Written CommunicationExcellent Verbal CommunicationInterpersonal SkillsTime ManagementOrganizational Skills
Certifications & Qualifications
Self-Insured CertificateWorkers' Compensation License
Industry Keywords
Claims ReviewsCalifornia ResidencyClient Guidelines ComplianceReturn-to-Work CoordinationClaim Recovery Management
About the role
Key responsibilities & impact- Handle complex and high-profile Workers' Compensation claims following company standards
- Receive claims, confirm policy coverage, and acknowledge claims
- 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 subrogation and litigation
- Manage potential claim recoveries
- Report claims to the excess carrier 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, and safety requirements
- 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 assist team members to develop knowledge and understanding of claims practice
- 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 the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation
- Must reside in California
Benefits
Comp & perks- 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
- Paid time off
- Career advancement opportunities
- Remote work