Medical Only Claims Specialist
CorVel is seeking a Medical Only Claims Specialist for our Nevada office. The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers compensation claims under close supervision, supporting the goals of claims department and of CorVel. Applicant must possess NV Workers Compensation Adjusters License
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Receives claims, confirms policy coverage and acknowledgement of the claim
- Determines the validity and compensability of the claim
- Establishes reserves and authorizes payments within established reserving authority limits
- Communicates claim status with the customer, claimant and client.
- Adheres to client and carrier guidelines and participates in claims review as needed.
- Assists other claims professionals with more complex or problematic claims as necessary.
- Additional projects and duties as assigned.
KNOWLEDGE & SKILLS:
- Excellent Customer Service Skills
- Excellent written and verbal communication skills.
- Ability to learn rapidly to develop knowledge and understanding of claims practice, relevant statutes and medical terminology.
- 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 1 year industry experience and claim handling
- WI experience required
- Licensed as required jurisdictionally
- Must possess NV Workers Compensation Adjusters License
In order to provide equal employment and advancement opportunities to all individuals, employment decisions at CorVel will be based on merit, qualifications and abilities. Except where required or permitted by law, employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex, national origin, ancestry, citizenship, age, handicap or disability, marital status, medical condition or any other characteristic protected by applicable law.
Please be aware that CorVel generally does not review all applications submitted in response to job openings posted on the Internet because of the large volume of responses.
Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes.