Medical Only Claims Specialist at CorVel Corporation in Folsom, CA

Job description

• 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.

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

Requirements

• 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
• 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

Skills

Required

• Excellent customer service skills

Benefits

• 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.