- 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 projects and duties as assigned.
- Excellent written and verbal communication skills.
- Ability to assist team members 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 work both independently and within a team environment
- Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation.
- Bachelor's degree or a combination of education and related experience.
- Minimum of 3 years' industry experience and claim handling
- Self-Insured Certificate preferred
- State Certification as an experienced Examiner
-
Claims Specialist
2 days ago
SkinCure Oncology Burr Ridge, United StatesLarge Growth - multiple positions needed · $1,000 sign-on bonus at 6 months · SkinCure Oncology is the national leader in the delivery of superficial radiation therapy services. We are currently recruiting for a full time Claims Integrity Specialist to join our team. SkinCure's C ...
-
Workers Compensation Claims Specialist
4 days ago
CNA Insurance Lisle, United StatesYou have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest pot ...
-
Claims Specialist, Medical Professional
2 weeks ago
Context4 Healthcare Naperville, United StatesContext4 Healthcare, Inc., located in Naperville, Illinois, is a world class employer where ingenuity and passion are welcomed. We are a market leader in healthcare compliance, reimbursement and regulatory products. We value our employees, clients, and partners and dedicate our e ...
-
Claims Specialist, Property
3 weeks ago
Zurich Insurance Company Ltd. Schaumburg, United StatesWe are currently seeking an individual interested in expanding their insurance career in commercial property technical claims handling, while working closely with a team of individuals with varied backgrounds and experiences. · At this level, you will handle a caseload of commerc ...
-
Claims Specialist L
3 weeks ago
Dovenmuehle Mortgage, Inc. Lake Zurich, United States**Claims Specialist I** · Full time; Non-Exempt; 40 hours/week; Overtime as required. · Location; Lake Zurich, IL, US · **Department**:Claims/REO · Dovenmuehle Mortgage, Inc. ("Dovenmuehle") is the leading mortgage subservicing firm in the United States with several hundred finan ...
-
Senior Claims Specialist
3 weeks ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job Description · CorVel is hiring a remote Senior Claims Specialist. The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to d ...
-
Senior Claims Specialist
2 weeks ago
CorVel Corporation Downers Grove, United States OTHERThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation a ...
-
Senior Claims Specialist
5 days ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job Description · The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case manage ...
-
Senior Claims Specialist
1 week ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job DescriptionCorVel is hiring a remote Senior Claims Specialist. The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determ ...
-
Senior Claims Specialist
3 weeks ago
CorVel Downers Grove, United StatesThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation a ...
-
Senior Claims Specialist
1 week ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job DescriptionThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers an ...
-
Complex Claims Specialist
2 weeks ago
CNA Insurance Chicago, United StatesYou have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest pot ...
-
Workers Compensation Claims Specialist
3 weeks ago
Liberty Mutual Hoffman Estates, United States**Pay Philosophy** · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in the ...
-
Revenue Cycle Claims Specialist
1 week ago
USA Clinics Group Northbrook, United StatesUSA Clinics Group is seeking an experienced and highly detailed **Revenue Cycle Claims Specialist **to join our Revenue Cycle team The **Revenue Cycle Claims Specialist** is the primary source for managing patient's delinquent accounts including sending patients to collections. T ...
-
Claims Customer Care Specialist
2 weeks ago
Allstate Chicago, United StatesThe world isn't standing still, and neither is Allstate. We're moving quickly, looking across our businesses and brands and taking bold steps to better serve customers' evolving needs. That's why now is an exciting time to join our team. You'll have opportunities to take risks, c ...
-
Workers' Compensation Claims Specialist
2 weeks ago
CorVel Corporation Downers Grove, United States OTHERCorVel is hiring a Claims Specialist for our VA office. The Claims Specialist manages lower-level, non-complex and non-problematic Medical Only workers' compensation claims along with Lost Time claims involving greater complexity - within company best practices & within delegated ...
-
Worker's Compensation Claims Specialist
2 weeks ago
Insight Global Downers Grove, United StatesInsight Global is looking for a Claims Specialist to join a third party workers compensation organization headquartered in Chicago, IL. The Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims ...
-
Workers' Compensation Claims Specialist
3 weeks ago
CorVel Downers Grove, United StatesCorVel is hiring a Claims Specialist for our VA office. The Claims Specialist manages lower-level, non-complex and non-problematic Medical Only workers' compensation claims along with Lost Time claims involving greater complexity - within company best practices & within delegated ...
-
Workers' Compensation Claims Specialist
2 days ago
CorVel Downers Grove, United StatesCorVel is hiring a Claims Specialist for our VA office. The Claims Specialist manages lower-level, non-complex and non-problematic Medical Only workers' compensation claims along with Lost Time claims involving greater complexity - within company best practices & within delegated ...
-
Workers' Compensation Claims Specialist
3 weeks ago
CorVel Enterprise Comp, Inc. Downers Grove, United StatesJob Description · Job Description · CorVel is hiring a Claims Specialist for our VA office. The Claims Specialist manages lower-level, non-complex and non-problematic Medical Only workers' compensation claims along with Lost Time claims involving greater complexity - within com ...
Senior Claims Specialist - Downers Grove, United States - CorVel Corporation
Description
CorVel is hiring a remote Senior Claims Specialist. The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
KNOWLEDGE & SKILLS:
EDUCATION/EXPERIENCE:
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: $58,282 – $93,870
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
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.
#LI-Remote