Lower Providence Township, Pennsylvania, United States · Remote OK
$61k–$98k/yr
Mid level
The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settle…
We are seeking an experienced Price Analyst II with 3-5+ years of experience in pricing analysis, market research, and strategic pricing initiatives. This mid-level role focuses on developing pricing strategies, conducti…
Downers Grove, Illinois, United States · Remote OK
$61k–$98k/yr
Mid level
The Care Advocate Nurse oversees initiatives surrounding assessing the severity of the injured workers’ reported injury(ies), reviews medical data in CareMC, validates and secures medical information, assesses and …
Skills: Workers Compensation, Clinical Nursing, Case Management, Medical Documentation, Patient Assessment
Downers Grove, Illinois, United States · Remote OK
$83k–$127k/yr
Senior+
The Casualty General Adjuster manages within company standards and best practices to investigate, evaluate, and handle to conclusion complex injury claims in litigation. Handle as required in specific customer service re…
Downers Grove, Illinois, United States · Remote OK
$15/hr–$23/hr
Senior
The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients.…
The Claims Assistant will support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific customer needs. This is a hybrid role. E…
Skills: Written Communication, Verbal Communication, Microsoft Word, Microsoft Excel, Organizational Skills
Lower Providence Township, Pennsylvania, United States · Hybrid
$13/hr–$23/hr
Entry level
The Claims Assistant will support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific customer needs. This is a hybrid role. E…
Skills: Written Communication, Verbal Communication, Microsoft Word, Microsoft Excel, Organizational Skills
CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Troy, AL area that is able to service the Dothan, AL area and the Montgomer…
Skills: Medical Case Management, Patient Assessment, Care Planning, Cost Containment, Utilization Review
The Director, Specialty Networks Product is a strategic leadership role within CorVel’s Network Services division. This position is responsible for overseeing the full product life cycle of the Pharmacy Benefit Man…
Telephonic Case Manager I - California RN License Required
Baltimore County, Maryland, United States · Remote Solely
$64k–$95k/yr
Mid level
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to wo…
Skills: Case Management, Clinical Assessment, Care Planning, Medical Recommendation, Cost Containment
The CareIQ Billing Specialist completes invoicing processes for all CareIQ Ancillary Healthcare services. Utilizing proprietary systems and knowledge from training, a CareIQ Billing Specialist will complete administrativ…
Skills: Invoicing, Billing Review, Customer Service, Data Entry, Microsoft Office
Charlotte, North Carolina, United States · Remote OK
$53k–$85k/yr
Entry level
The Workers’ Compensation Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible …
Skills: Written Communication, Verbal Communication, Problem Solving, Microsoft Office, Excel
Customer Service Representative I - Bilingual (Spanish)
Phoenix, Arizona, United States · Remote OK
$13/hr–$21/hr
Entry level
The Customer Service Representative is responsible for addressing client and/or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as c…
Skills: Bilingual Spanish, Customer Service, Workers Compensation Knowledge, Verbal Communication, Written Communication
Customer Service Representative I - Bilingual (Spanish)
Dallas, Texas, United States · Remote OK
$13/hr–$21/hr
Entry level
The Customer Service Representative is responsible for addressing client and/or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as c…
Skills: Spanish Bilingualism, Customer Service, Workers Compensation Knowledge, Verbal Communication, Written Communication
The Revenue Cycle Specialist is responsible for analysis and monitoring of claims audit data across multiple platforms. Performs various follow-up activities to ensure the accuracy and appropriateness of reimbursement ma…
East Hartford, Connecticut, United States · Hybrid
$53k–$85k/yr
Mid level
The Account Executive is responsible for interacting with customers and prospects on an executive level and acting as an extension of the client; selling new services, understanding and communicating agreed upon expectat…
Skills: Sales, Relationship Building, Presentation Skills, Customer Service, Time Management
CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Dallas, TX. Work from home, and on the road. Monday – Friday, regular bus…
Skills: Medical Case Management, Spanish Fluency, Patient Assessment, Care Planning, Utilization Review
The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, e…
Skills: Analytical Skills, Problem-solving, Attention To Detail, MS Word, MS Excel
Washington, District of Columbia, United States · Remote OK
$70k–$117k/yr
Mid level
The Account Executive is responsible for interacting with customers and prospects on an executive level and acting as an extension of the client; selling new services, understanding and communicating agreed upon expectat…
Skills: Sales, Relationship Building, Presentation Skills, Customer Service, Business Acumen
Charlotte, North Carolina, United States · Remote OK
$70k–$117k/yr
Mid level
The Account Executive is responsible for interacting with customers and prospects on an executive level and acting as an extension of the client; selling new services, understanding and communicating agreed upon expectat…
Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.
$61k–$98k/yr
Full-time
bachelor degree, professional certificate
Medical Insurance, Pharmacy, Dental Insurance, Vision Insurance, Long Term Disability, Health Savings Account
Posted 22d ago
~40 hrs/week
Remote in United States
Responsibilities
The Senior Claims Specialist manages complex Workers' Compensation claims, focusing on investigation, reserving, and settlement negotiations. The role involves coordinating with case managers and attorneys to reduce claim costs and ensure optimal outcomes for customers.
Requirements
Candidates need a bachelor's degree or equivalent experience and at least 3 years of industry experience in claim handling. Required certifications include a state license as an experienced claims adjuster and a current Workers' Compensation certification.
Full job description
The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.
This role is available for both remote and hybrid work arrangements.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives Workers’ Compensation 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 duties as assigned
KNOWLEDGE & SKILLS:
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 Microsoft 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
EDUCATION & EXPERIENCE:
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 or license as an experienced claims adjuster
Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel
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.
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
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.
Raising the bar for care. Lowering risk for clients.
Industry
Insurance
Company size
1,001-5,000 employees
Founded
1987
Headquarters
Irvine, CA
LinkedIn followers
35,764
CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry. Our mission is to take care of people and business with risk management solutions that deliver better outcomes for our partners. We are publicly traded (NASDAQ:CRVL), and annual revenues exceed $959 million. Our continuous investments in technology, infrastructure, and human capital allow us to offer local customer service backed by national resources.
Offices: 1920 Main St, Suite 900, Irvine, CA 92614, US · 5th Avenue, Portland, OR 97204, US
Workers' CompensationMedical Bill ReviewCase ManagementPPO ManagementTelehealthReturn to WorkRisk ManagementAuto LiabilityGeneral LiabilityClaims Management
Raising the bar for care. Lowering risk for clients.
Industry
Insurance
Company size
1,001-5,000 employees
Founded
1987
Headquarters
Irvine, CA
LinkedIn followers
35,764
CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry. Our mission is to take care of people and business with risk management solutions that deliver better outcomes for our partners. We are publicly traded (NASDAQ:CRVL), and annual revenues exceed $959 million. Our continuous investments in technology, infrastructure, and human capital allow us to offer local customer service backed by national resources.
Offices: 1920 Main St, Suite 900, Irvine, CA 92614, US · 5th Avenue, Portland, OR 97204, US
Workers' CompensationMedical Bill ReviewCase ManagementPPO ManagementTelehealthReturn to WorkRisk ManagementAuto LiabilityGeneral LiabilityClaims Management