Senior Claims Specialist FLOAT

CorVel
Las Vegas, NV
Remote
Job Description
The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards, working closely with case managers and attorneys, and ensuring the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.

Requirements

  • Receives 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 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 duties as assigned

Benefits

  • Medical (HDHP) with 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
  • Paid Time Off
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