The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publically traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 3500 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes 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, and paid time off.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Receives claims, confirms policy coverage and acknowledgment of the claim.
- Determines validity and compensability of the claim.
- Establishes reserves and authorizes payments within reserving authority limits.
- Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision.
- 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.
- Requires regular and consistent attendance.
- Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).
- Additional projects and duties as assigned.
KNOWLEDGE & SKILLS:
- Excellent written and verbal communication skills.
- Ability to learn rapidly 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 meet or exceed performance competencies.
- Ability to work both independently and within a team environment.
- Bachelor's degree or a combination of education and related experience.
- Minimum of 5 years of industry experience and claims management preferred.
- PA jurisdiction experience required.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.