Claims Specialist
CorVel
Job Summary
CorVel is hiring a Remote Claims Specialist to manage lower-level workers’ compensation claims, verify coverage, determine claim validity, authorize payments, communicate claim status, and support claims resolution under senior-level supervision.
Job Description
The Claims Specialist manages lower-level, non-complex workers’ compensation claims within delegated authority and under the supervision of a senior claims professional. This role includes receiving claims, confirming policy coverage, determining claim validity and compensability, establishing reserves, authorizing payments, and maintaining claim communication with customers, claimants, and clients.
This position supports medical-only claims and minor lost-time workers’ compensation claims while following company best practices, client guidelines, carrier requirements, and claims department procedures. The role requires strong communication, organization, problem-solving, and documentation skills.
### Key Responsibilities
* Receive and review workers’ compensation claims
* Confirm policy coverage
* Acknowledge claims according to guidelines
* Determine claim validity and compensability
* Establish reserves within authority limits
* Authorize payments within delegated authority
* Manage non-complex medical-only claims
* Manage minor lost-time workers’ compensation claims
* Communicate claim status to customers, claimants, and clients
* Follow client and carrier guidelines
* Participate in claim reviews as needed
* Assist claims professionals with more complex claims
* Complete additional duties as assigned
### Requirements
* Bachelor’s degree or equivalent education and experience
* Strong written and verbal communication skills
* Ability to learn claims practices quickly
* Strong analytical and problem-solving skills
* Microsoft Office proficiency
* Excel spreadsheet experience
* Strong interpersonal skills
* Strong time management and organizational skills
* Ability to work independently and within a team
* Ability to meet performance standards
### Preferred Qualifications
* 1+ year claims industry experience
* Claims management experience
* Workers’ compensation claims experience
* Insurance industry experience
* State Certification as an Experienced Examiner
### Benefits
* Medical Insurance
* Dental Insurance
* Vision Insurance
* 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
* 401(k)
* Roth 401(k)
* Paid Time Off
### Phone Level Breakdown
* Claims documentation: High
* Claimant communication: Moderate
* Client communication: Moderate
* Payment/reserve processing: Moderate
* Customer calls/emails: Moderate