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CorVel Corporation delivers integrated risk management and healthcare services for payors and employers. Its work spans workers’ compensation, liability and disability management, provider and pharmacy networks, and alternative risk solutions. The company combines claims expertise with AI-enabled technology and data analytics to help streamline administration, support better care and claims outcomes, and manage costs.
Senior Workers' Compensation Claims Specialist | California Remote
CorVel seeks a senior claims specialist to manage complex workers' compensation claims remotely from California. The role covers investigations, case coordination, recoveries, reserves, regulatory filings, and settlement negotiations.
Description
- Manage complex and high-profile workers' compensation claims in line with company standards
- Collaborate with case managers and attorneys
- Oversee subrogation, litigation, and potential claim recoveries
- Negotiate claim settlements
- Receive workers' compensation claims and verify policy coverage and acknowledgments
- Investigate claims to determine validity and compensability
- Submit required documentation to state agencies
- Set reserves and authorize payments within delegated authority
- Create and manage documented action plans with case and outcomes managers to reduce claim costs
- Coordinate early return-to-work initiatives
- Report applicable claims to excess carriers
- Update customers and claimants on claim status
- Follow client, carrier, state, and regulatory requirements
- Participate in claims reviews as needed
- Build and maintain professional customer relationships
- Follow workplace safety rules and regulations
- Complete other assigned duties
Requirements
- Bachelor's degree or an equivalent combination of education and relevant experience
- At least three years of industry experience, including claims handling
- Self-Insured Certificate preferred
- State certification or licensing as an experienced claims adjuster
- Maintain a current workers' compensation license or certification throughout employment with CorVel
- Strong written and verbal communication skills
- Ability to help teammates build claims-practice knowledge
- Ability to identify, analyze, and resolve problems
- Proficiency with computers and technical tools, including Microsoft Office and Excel
- Strong interpersonal, organizational, and time-management skills
- Ability to work independently and collaboratively
- Knowledge of workers' compensation claims administration, case management, and cost-containment solutions as applicable
Benefits
- Medical coverage through a high-deductible health plan with pharmacy benefits
- Dental insurance
- Vision insurance
- Long-term disability coverage
- Health Savings Account
- Flexible Spending Account options
- Life insurance
- Accident insurance
- Critical illness insurance
- Prepaid legal insurance
- Parking and transit Flexible Spending Accounts
- 401(k) plan
- Roth 401(k) plan
- Paid time off
- Career advancement opportunities
- Supportive workplace culture
- Remote work
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