Remote Senior Claims Specialist – Workers' Comp

CorVel; Sacramento (CA); Remote; USD 40,000 - 65,000; Full time

Benefits offered by this job

Medical insurance

Dental & Vision

401K + Roth 401K

Paid time off

Job summary

CorVel is seeking a Senior WC Claims Specialist to handle complex workers' compensation claims, working with case managers and attorneys to pursue favorable outcomes. This remote role emphasizes subrogation management, settlements, and service excellence for clients.

You will establish reserves, authorize payments within authority, coordinate early return-to-work, and communicate status to claimants and customers. A strong background in claims practice and state compliance is expected.

Qualifications

• Bachelor's degree or combination of education and related experience.
• Minimum of 3 years industry experience and claim handling.
• Self-Insured Certificate preferred.
• State Certification or license as an experienced claims adjuster.
• Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel.

Responsibilities

• Receives Workers' Compensation claim, confirms policy coverage and acknowledgement of the claim.
• Determines validity and compensability of the claim by investigating and gathering information and filing necessary documentation.
• Establishes reserves and authorizes payments within reserving authority limits.
• Develops and manages action plans with the case manager to reduce overall cost of the claim.
• Coordinates early return-to-work efforts with the appropriate parties.
• Manages subrogation and litigation of claims as applicable.
• 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 reviews.
• Develops and maintains professional customer relationships.
• Complies with state rules and safety regulations.
• Performs additional duties as assigned.

Skills

Communication

Investigation

Problem solving

Teamwork

Office & Excel

Education

Bachelor's degree

Self-Insured Certificate

State claims adjuster license

Workers' Compensation license

Tools

Microsoft Office

Excel

Job description

CorVel is seeking a Senior WC Claims Specialist to handle complex workers' compensation claims, working with case managers and attorneys to pursue favorable outcomes. This remote role emphasizes subrogation management, settlements, and service excellence for clients.

You will establish reserves, authorize payments within authority, coordinate early return-to-work, and communicate status to claimants and customers. A strong background in claims practice and state compliance is expected.