[Hiring] Medical Only Claims Specialist @CorVel Career Site

Role 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 role; candidates must reside in New Mexico and have an active adjuster license in the state.

• 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

Qualifications

• 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

Requirements

• 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
• Must have an active adjuster license in the state

Benefits

• Comprehensive benefits package for full-time regular employees
• 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 and ROTH 401K
• Paid time off