CorVel Corporation · 1 day ago
CA WC Senior Claims Specialist
United States
Full-time
Remote
Mid, Senior Level
$28.69/hr - $46.21/hr
3+ years expCorVel Corporation is a national provider of industry-leading risk management solutions for various sectors including workers' compensation. The Senior Claims Specialist will handle complex Workers' Compensation claims, ensuring compliance with company standards while managing relationships with case managers and attorneys to achieve optimal outcomes.
InsuranceSoftware
Responsibilities
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
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)
Additional duties as assigned
Qualification
Required
Handles complex and high-profile Workers' Compensation claims following company standards
Works closely with case managers and attorneys
Manages subrogation and negotiates settlements
Ensures the best possible outcome for the claim
Meets customer service expectations
Supports the goals of the Claims Department and CorVel
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
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (IIPP)
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
Preferred
Self-Insured Certificate
State Certification as an experienced Examiner
Benefits
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
Paid time off
Company
CorVel Corporation
CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown1991-07-05IPO
Leadership Team
Jeff Gurtcheff
Chief Claims Officer
Maxim Shishin
CIO
Recent News
CorVel Corp.
2025-11-04
2025-10-22
2025-10-06
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