Senior Claims Specialist
at CorVel Corporation
Acton, MA 01720, USA -
Start Date | Expiry Date | Salary | Posted On | Experience | Skills | Telecommute | Sponsor Visa |
---|---|---|---|---|---|---|---|
Immediate | 02 Oct, 2024 | USD 93870 Annual | 03 Jul, 2024 | 3 year(s) or above | Communication Skills,Case Management,Time Management | No | No |
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Description:
The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers’ compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.
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, case management and cost containment solution as applicable to Workers’ Compensation.
EDUCATION/EXPERIENCE:
- 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 as an experienced Examiner
Responsibilities:
- Receives claim, confirms policy coverage and acknowledgement of the claim
- Determines validity and compensability 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 with the case manager and outcomes manager to reduce overall cost of the claim
- Coordinates early return-to-work efforts with the appropriate parties.
- Manages subrogation and litigation of claim as it applies
- Manages potential claim recoveries of all types
- Reports claims to the excess carrier when applicable
- Communicates claim status with the customer and claimant
- Adheres to client and carrier guidelines and participates in claims review as needed
- Develops and maintains professional customer relationships
- Complies with rules and regulations of applicable state
- Additional projects and duties as assigned.
REQUIREMENT SUMMARY
Min:3.0Max:8.0 year(s)
Insurance
Banking / Insurance
Insurance
Trade Certificate
Self-insured certificate preferred
Proficient
1
Acton, MA 01720, USA