CA WC Claims Specialist

Rancho Cucamonga, CA

Full-time

Remote

$24.91/hr - $40.17/hr

Entry Level

CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry. The Claims Specialist manages lower-level, non-complex workers’ compensation claims under the supervision of a senior claims professional, ensuring the best possible outcomes and supporting the goals of the claims department.

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Responsibilities

Receives claims, confirms policy coverage and acknowledgment of the claim
Determines validity and compensability of the claim
Establishes reserves and authorizes payments within reserving authority limits
Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision
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
Requires regular and consistent attendance
Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)
Additional projects and duties as assigned

Qualification

Required

Bachelor's degree or a combination of education and related experience
Excellent written and verbal communication skills
Ability to learn rapidly 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 meet or exceed performance competencies
Ability to work both independently and within a team environment