Senior WC Claims Specialist (Remote CA, Bilingual)

CorVel Corporation; Rancho Cucamonga (CA); On-site; USD 40,432 - 65,132; Full time

Benefits offered by this job

Medical insurance

401(k) plan

Paid time off

Job summary

CorVel Corporation seeks a WC Senior Claims Specialist to handle complex workers’ compensation claims, collaborating with case managers and attorneys. You will manage subrogation, negotiate settlements, and ensure service expectations align with department goals.

The role requires CA residency, bilingual ability, and a California self-insurance certification. You will assess claims, establish reserves, coordinate return‑to‑work, and maintain client relationships in a remote CA-based setup.

Qualifications

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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 regarding the claim and files necessary documentation with state agencies
• Establishes reserves and authorises 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
• 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

Excellent written and verbal沟通

Team collaboration

Problem solving

Organisational skills

Independent work

Education

Bachelor’s degree or combination of education and related experience

3+ years’ industry experience in claims handling

Self‑Insured Certificate preferred

State Certification or licence as an experienced claims adjuster

Current licence or certification in Workers’ Compensation

Tools

Microsoft Office

Excel

Job description

CorVel Corporation seeks a WC Senior Claims Specialist to handle complex workers’ compensation claims, collaborating with case managers and attorneys. You will manage subrogation, negotiate settlements, and ensure service expectations align with department goals.

The role requires CA residency, bilingual ability, and a California self-insurance certification. You will assess claims, establish reserves, coordinate return‑to‑work, and maintain client relationships in a remote CA-based setup.