- Receives claim, confirms eligibility for compensation and acknowledgement of the claim
- Determines validity 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 to reduce overall cost of the claim
- Manages subrogation and litigation of claim as it applies
- Manages potential claim recoveries of all types
- Communicates claim status with the customer and claimant
- Adheres to client guidelines and participates in claims review as needed
- Develops and maintains professional customer relationships
- Complies with rules and regulations of Tennessee
- 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 and cost containment solution as applicable to liability
- Bilingual Spanish preferred but not required.
- Bachelor's degree or a combination of education and related experience.
- General Liability and Auto Liability Experience with 1st Party, PD and BI experience a plus.
- Litigation knowledge a plus
-
Claims Resolution Specialist Claims Adjuster
1 week ago
Encova Insurance Ohio, United States Full timeESSENTIAL FUNCTIONS: · Investigate, evaluate, settle and process claims primarily on the phone with limited in-person contact. · Handle claims including injury and third party property damage claims primarily under personal and commercial auto and garage, uninsured and underinsur ...
-
Claim Benefit Specialist
1 week ago
C Vs Pharmacy Columbus, United StatesReviews and adjudicates routine Medicare claims on HRP system in accordance with claim processing guidelines. Claims adjudication results should meet/exceed production and quality standards in line with CMS and Aetna compliance and business requireme Specialist, Processing, Micro ...
-
Auto Claims Specialist
3 weeks ago
Installed Building Products Columbus, United StatesJob Description: · Compensation Range: $55,000 up to $65,000, Based on experience. · Installed Building Products (IBP) Is seeking a diligent and detail-oriented Auto Claims Specialist to join our team. Are you ready to look at the bigger picture and instigate change? Installed ...
-
Claim Data Specialist OPS, Claim Lifeline
3 weeks ago
C Vs Pharmacy Columbus, United StatesWe are looking for a highly motivated candidate who can work across teams to provide claim subject matter expertise. The Claim Lifeline Specialist will respond to Lifeline inquiries and handle real time member rework. The candidate selected should be Data Specialist, Member Servi ...
-
Auto Claims Specialist
4 weeks ago
Insight Global Columbus, United StatesJob Description · Day to Day/Core Responsibilities: · Administration of auto claims (physical damage and liability) by working directly with the third-party administrator claims management team, employees, and branch locations. · Point of contact for company branch locations conc ...
-
Auto Claims Specialist
3 days ago
Insight Global Columbus, United StatesDay to Day/Core Responsibilities: · •Administration of auto claims (physical damage and liability) by working directly with the third-party administrator claims management team, employees, and branch locations. · •Point of contact for company branch locations concerning auto cl ...
-
Auto Claims Specialist
3 weeks ago
Insight Global Columbus, United StatesDay to Day/Core Responsibilities: · Administration of auto claims (physical damage and liability) by working directly with the third-party administrator claims management team, employees, and branch locations. · Point of contact for company branch locations concerning auto clai ...
-
Property Claims Specialist
3 weeks ago
EMC Insurance Columbus, United StatesAt EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees. · **This posit ...
-
Senior Claim Benefit Specialist
2 weeks ago
C Vs Pharmacy Columbus, United StatesReviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. - Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical nec Specialist, Processing, Senio ...
-
Workers' Compensation Claims Specialist
2 weeks ago
City of Columbus Columbus, United StatesWorkers' Compensation Claims Specialist (Employee Benefits Analyst II) (Vacancy) · Print ) · Apply · ? · Workers' Compensation Claims Specialist (Employee Benefits Analyst II) (Vacancy) · Salary · $ $44.47 Hourly · Location · Varies by position · Job Type · Full-time · ...
-
Senior Claims Resolution Specialist
3 weeks ago
Encova Insurance Columbus, United StatesThe salary range for this job posting is $53, $86,059.00 annually + bonus + benefits · The above represents the salary range for this job requisition. Ultimately, in determining your pay, we'll consider your location, education, experience, and other job-related factors. Your re ...
-
Medical Only Claims Specialist
2 weeks ago
CorVel Corporation Ohio, United States OTHERThe Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers' compensation claims under close supervision, supporting the goals of claims department and of CorVel. · This is a hybrid role reporting to our Dublin, OH ...
-
Workers' Compensation Claims Specialist
2 weeks ago
City of Columbus Columbus, United StatesThe City of Columbus Department of Human Resources is seeking an experienced Workers Compensation claims specialist. The individual in this role will be responsible for the administration and management of the Citys Injury Leave (salary continuatio Claims Specialist, Benefits, Wo ...
-
Failed Claims Specialist 2
3 weeks ago
Ohio State University Wexner Medical Center Columbus, United StatesScope of Position · The Failed Claims Specialist 2 functions in the revenue management unit supporting hospital claims processing and charge capture processes. Responsible for maintaining current knowledge of the various regulatory agency guidelines and assure requirements are ...
-
Insurance Claims Invoicing Specialist
3 weeks ago
The Gilmore Group LLC Columbus, United StatesWe're looking for a skilled Invoicing Specialist professional for our Columbus Headquarters to handle invoice processing and project scope reviews on multiple construction projects. · Duties include but are not limited to: · Manage insurance claims and invoicing process · Ensu ...
-
WC Medical Claims Specialist
2 weeks ago
Ohio Department of Developmental Disabilities Columbus, United StatesPrimary Location · :United States of America-OHIO-Franklin County-Columbus Work Locations · :William Green Building30 West Spring StreetColumbus Organization · :Workers' CompensationClassified Indicator:ClassifiedBargaining Unit / Exempt:Bargaining Unit Schedule · :Full ...
-
Claims Support Specialist II
3 weeks ago
Erie Insurance Columbus, United StatesDivision or Field Office: · Columbus Branch Office · Department of Position: Claims Department · Work from: · Columbus Branch Office Salary Range: · (($31, $49, * · salary range is for this level and may vary based on actual level of role hired for · *This range represents a n ...
-
Workers' Comp Indemnity Claims Specialist
1 week ago
CorVel Corporation Franklin, United States Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of ...
-
Billing & Claims Specialist - Medi-cal Calaim
2 weeks ago
Omatochi Corp Dublin, United States**About Omatochi**: · Omatochi is a leading home care service provider dedicated to enhancing the quality of life for our clients. We specialize in delivering compassionate and high-quality care with a focus on personalized solutions. As we continue to grow, we are seeking a skil ...
-
Hastings Mutual Columbus, United StatesHastings Mutual is currently looking for a Property Claim Specialist to join its Large Loss Claim Team This is an excellent opportunity for an experienced property claim professional located in Michigan or Ohio to provide responsive and consultative-level responses for large loss ...
CIC, SAFE, and EMIF Claims Specialist - Franklin, United States - CorVel Corporation
Description
CorVel is Nashville, TN is hiring a remote, claims specialist. The CIC, SAFE, and EMIF Claims Specialist manages claims involving the Criminal Injuries Compensation Program (CIC); the Sexual Assault Forensic Exam Reimbursement Program (SAFE) and Electronic Monitoring Indigency Fund (EMIF) within company standards and best practices within delegated authority to determine benefits due; manage subrogation and negotiate settlements to ensure specific customer service requirements to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.
ESSENTIAL FUNCTIONS AND 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: $50,593 – $81,593
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 publically 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.
