The Non-Subscriber Claims Specialist manages within company best practices Texas Non-Subscriber claims within delegated limited authority to best possible outcome, under the direct supervision of a supervisor, supporting the goals of claims department and of CorVel.
This is a hybrid position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
- Receives claims, confirms employee eligibility, confirm timeliness of reporting, and confirms use of approved medical providers.
- Investigate liability potential and complete initiate contacts.
- Determines validity and if the injury is a Covered Injury.
- Establishes reserves and authorizes payments within reserving and payment authority limits.
- Manages Texas Non-Subscribers claim in accordance with Injury Benefit Plans.
- Responsible for writing Benefit Determination Letters, Non-Compliance Warning Letters and Compliance Letters in accordance with the Injury Benefit Plans.
- Calculate Wage Replacement Benefits according to the specifics of the Injury Benefit Plans.
- Adheres to client and carrier guidelines and participates in claims reviews.
- Requires regular and consistent attendance.
- Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”).
- Additional projects and duties as assigned.
KNOWLEDGE & SKILLS:
- Excellent written and verbal communication skills.
- Ability to learn rapidly 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 meet or exceed performance competencies.
- Ability to work both independently and within a team environment.
EDUCATION & EXPERIENCE:
- Bachelor degree or a combination of education and related experience.
- Minimum of 2 to 3 years of industry experience handling non-subscriber claims.
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.
ABOUT CORVEL:
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 enable 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!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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