Medical Only Claims Specialist

at  CorVel Corporation

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.
This is a hybrid position.

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

EDUCATION/EXPERIENCE:

• Bachelor’s degree or a combination of education and related experience
• Minimum of 1 year industry experience and claim handling
• WC experience required
• Licensed as required jurisdictionally

• 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