Northeast Workers’ Compensation Regulatory Specialist III

The Northeast Workers’ Compensation Regulatory Specialist is responsible for managing jurisdictional reporting, regulatory filings and compliance-related processes across the Northeast region.  This role ensures timely, accurate and compliant submission of filings, responses and payments to mitigate organizational risk and potential penalty exposure.

The Specialist oversees HP and C-8.1 activity from intake through resolution, supports FROI/SROI reporting and exception processes and assists with OSHA and Medicare validation initiatives.  This role partners closely with claim professionals and leadership to strengthen regulatory workflows, identify trends, reduce penalties and support broader regulatory projects as assigned.

 This is a hybrid role.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

Regulatory Filings & Compliance Oversight

• Manage HP and C-8.1 activity from intake through resolution, including review, rebuttal, corrective payment coordination and follow-up.
• Review C-8.1 filings and supporting documentation for appropriateness, accuracy and compliance with jurisdictional requirements.
• Support FROI/SROI submission processes, including monitoring rejections, clearing exceptions and resolving reporting discrepancies.
• Partner with claim professionals to ensure filings and payments meet jurisdictional deadlines and compliance standards.
• Follow up with regulatory submissions to proactively prevent penalties and adverse findings.

Exception Processing & Reporting Support

• Work through jurisdictional reporting exceptions to ensure timely resolution.
• Identify root causes of filing errors, system issues or workflow gaps.
• Recommend process improvements to reduce recurring exceptions or penalties.
• Assist with OSHA reporting and Medicare validation efforts to ensure regulatory accuracy and completeness.

Analysis, Trending & Risk Mitigation

• Track outcomes of HPs, C-8.1s, FROI/SROI filings and penalties for trend analysis.
• Analyze penalty activity and identify patterns, training gaps or operational concerns.
• Provide regular updates to management regarding regulatory exposure and compliance trends.
• Ensure penalties are properly reviewed, documented and timely paid when applicable.

Training & Subject Matter Expertise

• Serve as a subject matter expert on New York Workers’ Compensation regulatory requirements and Northeast jurisdictional guidelines.
• Provide training and guidance to claim professionals regarding filing requirements, internal workflows and compliance best practices.
• Assist in implementation and refinement of regulatory processes and workflows.
• Support onboarding and continuing education initiatives related to jurisdictional reporting.

Additional Responsibilities

• Support regional regulatory initiatives and specialist projects, as assigned.
• Maintain working knowledge of department functions and communicate regulatory requirements clearly across all levels of the organization.
• Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
• Maintain regular and consistent attendance.
• Perform additional duties as assigned.

 KNOWLEDGE & SKILLS:

• Active New York State Adjuster’s License required.
• Strong knowledge of New York Workers’ Compensation regulations; familiarity with Northeast jurisdictional reporting requirements preferred.
• Experience with HP and C-8.1 filings required.
• Working knowledge of FROI/SROI reporting processes and exception management preferred.
• Familiarity with OSHA reporting and Medicare validation processes preferred.
• Excellent written and verbal communication skills.
• Strong analytical skills with the ability to identify trends and recommend solutions.
• Ability to work independently while collaborating effectively across teams.
• Strong organizational, time management and prioritization skills.
• High attention to detail and accuracy.
• Proficiency in Microsoft Office and claims management systems.

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.

Pay Range:  $58,126 - $86,947 

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

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.

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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Salary : $58,126 - $86,947