Senior Claims Specialist

CorVel Co. • Remote (MA, United States) • $200k - $250k / year • 1w ago

Job Location: MA - Boston Acton
31 Nagog Park
Suite 305
Acton, MA 01720, USA

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 requirements to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Receives claim, confirms policy coverage and acknowledgment 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

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

PAY RANGE:

CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enables us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).