Remote Senior Workers’ Comp Claims Specialist

CorVel Corporation; Rancho Cucamonga (CA); Remote; USD 85,000 - 110,000; Full time

Job summary

CorVel Corporation is seeking a WC Senior Claims Specialist for a remote role based in the United States. The position handles complex workers’ compensation claims, works with case managers and attorneys, and oversees subrogation and settlements to achieve favorable outcomes.

You will determine claim validity, establish reserves, and coordinate early return-to-work efforts while maintaining strong customer relationships and compliance with state rules.

Qualifications

• Bachelor's degree or equivalent; 3+ years workers' compensation claims experience.
• Current license or certification in Workers’ Compensation maintained.
• Self-Insured Certificate preferred; state certification or license as claims adjuster.
• Proficient in claims administration and cost containment practices.

Responsibilities

• Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim.
• Determines validity and compensability by investigating and filing necessary documentation with state agencies.
• Establishes reserves and authorizes payments within reserving authority limits.
• Develops and manages 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.
• Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (IIPP).
• Additional duties as assigned.

Skills

Communication

Teamwork

Problem solving

Time management

Attention to detail

Independent work

Claims knowledge

Education

Bachelor's degree or equivalent

State Certification or license

Self-Insured Certificate preferred

Tools

Microsoft Office (Excel)

Job description

CorVel Corporation is seeking a WC Senior Claims Specialist for a remote role based in the United States. The position handles complex workers’ compensation claims, works with case managers and attorneys, and oversees subrogation and settlements to achieve favorable outcomes.

You will determine claim validity, establish reserves, and coordinate early return-to-work efforts while maintaining strong customer relationships and compliance with state rules.