What are the responsibilities and job description for the Medical Only Claims Specialist position at CorVel Brand?
The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
- Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of the claim
- Determines the validity and compensability of the claim
- Establishes reserves and authorizes payments within established reserving authority limits
- Communicates claim status with the customer, claimant and client
- Adheres to client and carrier guidelines and participates in claims review as needed
- Assists other claims professionals with more complex or problematic claims as necessary
- Additional duties as assigned
KNOWLEDGE & SKILLS:
- Excellent customer service skills
- Excellent written and verbal communication skills
- Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
- Ability to identify, analyze and solve problems
- Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
- Strong interpersonal, time management, and organizational skills
- Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
- Bachelor's degree or a combination of education and related experience
- Minimum of 1 year industry experience and claim handling
- Workers’ Compensation experience required
- Licensed as required jurisdictionally
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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