- 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
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Senior Claims Specialist
3 weeks ago
CorVel Corporation Tampa, United States Full timeThe 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 ...
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Senior Claims Specialist
3 weeks ago
Freelance Recruiters Tampa, United States Full timeOur client, based out of Tampa, FL, serves as a dedicated strategic partner to government and other agencies and is seeking a Sr. Specialist, Claims, who will be responsible for managing workers' compensation claims activity from conception to resolution. · This is a fully remot ...
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Claims Resolution Specialist
3 weeks ago
Acosta Group Tampa, United States**DESCRIPTION** · The Claims Resolution Specialist is responsible for validating and clearing claims against promotional offers, analyzing claims to determine their validity, and clearing claims in accordance with Acosta, client and customer policies and procedures. The Claims R ...
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Senior Claims Specialist
4 weeks ago
Freelance Recruiters Tampa, United StatesJob Description · Job DescriptionOur client, based out of Tampa, FL, serves as a dedicated strategic partner to government and other agencies and is seeking a Sr. Specialist, Claims, who will be responsible for managing workers' compensation claims activity from conception to res ...
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Senior General Liability Claims Specialist
2 weeks ago
CorVel Corporation Tampa, United States Full timeCorVel is seeking a Senior General Liability Claims Specialist. The Senior General Liability Claims Specialist manages within company best practices Commercial General Liability PD and BI Claims, including litigated matters. This role is primarily Premises General Liability, but ...
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Claims Resolution Specialist 2
1 hour ago
Tampa General Hospital Tampa, United StatesResponsible for prompt and accurate follow-up of all unpaid claims. Reviews assigned accounts to determine appropriate action needed with regards to claim resolution. Handles large payer projects as assigned by Department Manager. Responsible for 2nd Claims, Specialist, Healthcar ...
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Claims Administrative Support Specialist
21 hours ago
Progressive Corp Tampa, United StatesClaims Administrative Support Specialist - Intermediate **Job Number** · : As a **claims administrative support specialist**, youll play a vital role supporting our claims branch offices. In addition to ensuring essential administrative functions run smoothly, you may also inter ...
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Claims Resolution Specialist 1
3 weeks ago
The Tampa General Hospital Foundation Inc Tampa, United StatesUniversity of South Florida Tampa General Physicians (USFTGP) was created through an advanced affiliation between The University of South Florida and Tampa General Hospital to provide advanced care to patients and their families throughout Florida. Specialties include cardiology, ...
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Claims Resolution Specialist 1
3 weeks ago
USF Health Tampa, United StatesJob Summary: · Responsible for prompt and accurate submission and follow-up of all third party claims. Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure reimbursement. Reviews assigned accounts, determines appropriate action to resolve ou ...
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Claims Resolution Specialist 1
1 hour ago
USF Health Tampa, United StatesUniversity of South Florida Tampa General Physicians (USFTGP) was created through an advanced affiliation between The University of South Florida and Tampa General Hospital to provide advanced care to patients and their families throughout Florida. Specialties include cardiology, ...
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Claims Resolution Specialist
2 weeks ago
Acosta Group Tampa, United States**RESPONSIBILITIES** · + Trains and mentors Claim associates on validating and clearing claims in accordance with Acosta, client and customer policies and procedures. · + Assumes supervisory responsibilities in the absence of the Claims Resolution Supervisor · + Assists the Cl ...
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Claims Resolution Specialist
4 weeks ago
Acosta Group Tampa, United States**RESPONSIBILITIES** · + Trains and mentors Claim associates on validating and clearing claims in accordance with Acosta, client and customer policies and procedures. · + Assumes supervisory responsibilities in the absence of the Claims Resolution Supervisor · + Assists the Cl ...
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Senior Claims Specialist
2 weeks ago
CorVel Tampa, 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 ...
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Liberty Mutual Insurance Tampa, United States Full timePay 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 these ...
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Senior General Liability Claims Specialist
2 weeks ago
CorVel Enterprise Comp, Inc. Tampa, United StatesJob Description · Job DescriptionCorVel is seeking a Senior General Liability Claims Specialist. The Senior General Liability Claims Specialist manages within company best practices Commercial General Liability PD and BI Claims, including litigated matters. This role is primarily ...
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Florida Workers' Compensation Claims Specialist
3 weeks ago
CorVel Enterprise Comp, Inc. Tampa, United StatesJob Description · Job DescriptionThe 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 attor ...
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Sr. Claims Specialist
3 weeks ago
Advanced Dynamics Corp Tampa, United StatesThis is a remote position. · Job Title: Sr. Specialist, Claims · Classification: Salaried, Exempt (FTE) · Reports To: Director of Risk Management · Last Modified: 04/29/2024 · Our client serves as a dedicated strategic partner to government and other clients. We seek to hire peop ...
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Casualty Claims Specialist
2 weeks ago
American National Family of Companies Tampa, United States**Casualty Claims Specialist**: · **What You'll Do** · - Investigate, evaluate, and settle casualty claims in accordance with company policies and procedures. · - Conduct detailed assessments of claims to determine liability, damages, and appropriate settlements. · - Communicate ...
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Senior Claims Specialist
4 weeks ago
CRC Group Tampa, United StatesThe position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. · Need Help? · If you have a disability and need assistance with the application, you can reque ...
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Claims Resolution Specialist
3 weeks ago
Acosta Group Tampa, United States**RESPONSIBILITIES** · + Trains and mentors Claim associates on validating and clearing claims in accordance with Acosta, client and customer policies and procedures. · + Assumes supervisory responsibilities in the absence of the Claims Resolution Supervisor · + Assists the Cl ...
Senior Claims Specialist - Tampa, United States - CorVel Enterprise Comp, Inc.
Description
Job 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 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.
This is a hybrid position.
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-Hybrid
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