The CIC, SAFE, and EMIF Claims Specialist manages claims involving the Criminal Injuries Compensation Program (CIC); the Sexual Assault Forensic Exam Reimbursement Program (SAFE) and Electronic Monitoring Indigency Fund (EMIF) within company standards and best practices within delegated authority to determine benefits due; manage subrogation and negotiate settlements to ensure specific customer service requirements to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Receives claim, confirms eligibility for compensation and acknowledgement of the claim
- Determines validity of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies
- Establishes reserves and authorizes payments within reserving authority limits
- Develops and manages well documented action plans to reduce overall cost of the claim
- Manages subrogation and litigation of claim as it applies
- Manages potential claim recoveries of all types
- Communicates claim status with the customer and claimant
- Adheres to client guidelines and participates in claims review as needed
- Develops and maintains professional customer relationships
- Complies with rules and regulations of Tennessee
- Additional projects and duties as assigned
KNOWLEDGE & SKILLS:
- 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.
- Knowledge of the entire claims administration and cost containment solution as applicable to liability.
- Bachelor's degree or a combination of education and related experience.
- General Liability and Auto Liability Experience with 1st Party, PD and BI experience a plus.
- Litigation knowledge a plus