senior claims specialist

Trillium Health Resources

<div><div><b>Pay Plan Title: </b>Data Analyst</div><div><b>
Working Title: </b>Senior Claims Specialist</div><div><b>
FLSA Status: </b>Exempt</div><div><b>
Posting Salary Range: </b>$41,102 - $59,518</div><div><b>
Office Location: </b>Remote within North Carolina</div><div></div><div><b><br>
POSTING DETAILS:</b></div><div></div><div><b><br>
Make an Impact</b></div><div></div><div><br>
Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.</div><div></div><div><b><br>
Why Work for Us</b>?</div><div></div><div><br>
Trillium believes that empowering others begins with supporting our team. We offer our employees:</div><div></div><div><br>
<ul><li>
A collaborative, mission-driven work environment</li><li>
Competitive benefits and work-from-home options for most positions</li><li>
Opportunities for professional growth in a diverse inclusive culture</li></ul></div><div></div><div><br>
Every day, our work changes lives &ndash; from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.</div><div></div><div><br>
If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!</div><div></div><div><b><br>
What We&rsquo;re Looking For</b></div><div></div><div><br>
Trillium Health Resources has a career opening for a Senior Claims Specialist to join our team! The Senior Claims Specialist performs data analysis, auditing and finalizes adjudication results for claims designated for pre-payment review and post payment review of claim adjudication results through research and knowledge of billing guidelines and policies established by CMS, and NC Medicaid as well as Trillium policies and procedures. This position is also responsible for assisting providers by phone or email with claims processing questions as well as communicating with internal and external stakeholders to facilitate efficient claims resolution.</div><div></div><div><b><br>
On a typical day, you might:</b></div><div></div><div><br>
<ul><li>
Analyze and audit claims adjudication results to determine if claims were accurately submitted and processed according to NC Medicaid guidelines.</li><li>
Analyze and audit claim attachments/medical documentation necessary to appropriately adjudicate a claim.</li><li>
Analyze, audit and take appropriate actions for claims delayed for adjudication due to rejection errors.</li><li>
Identify adjudication errors, provider billing errors, and the need for technical assistance.</li><li>
Ensure the claims system and manual processes are incorporating required actions by reviewing and applying information from departmental trainings, published coverage policies and other NCDHHS documents.</li><li>
Provide training, education and technical assistance to provider agencies based on analysis or audit findings related to basic claim submission guidelines, denial management, system use and updates.</li><li>
Recognize and report suspected system issues or concerns to immediate supervisor for follow-up based on data analysis.</li></ul></div><div></div><div><b><br>
Employee Benefits:</b></div><div></div><div><br>
Trillium knows that work/life balance is essential. That&rsquo;s why we offer:</div><div></div><div><br>
<ul><li>
Typical working hours: 8:30 am &ndash; 5:00 pm; flexible work schedules with some roles with management approval.</li><li>
Work-from-home options available for most positions</li><li>
Health Insurance with no premium for employee coverage</li><li>
Flexible Spending Accounts</li><li>
24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year</li><li>
NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook</li><li>
401k with 5% employer match and immediate vesting</li><li>
Public Service Loan Forgiveness (PSLF) qualifying employer</li><li>
Quarterly stipend for remote work supplies</li></ul></div><div></div><div><b><br>
Qualifications</b></div><div></div><div><br>
Required:</div><div><ul><li>
High School Diploma/GED and two (2) years of experience in the claims processing or billing or medical coding field; OR</li><li>
Equivalent combination of education/experience.</li><li>
Must have a valid driver&rsquo;s license</li><li>
Must reside within North Carolina</li><li>
Must be able to travel within catchment as required.</li></ul></div><div></div><div><br>
Preferred:</div><div><ul><li>
Associate&rsquo;s degree in Healthcare Administration, Business, or a Human Services field (such as Psychology, Social Work, etc.)</li></ul></div><div><ul><li>
 Hospital claims experience and knowledge</li><li>
 Experience in the areas of physical health claims processing or medical coding</li><li>
 Experience working with Managed Care billing software</li><li>
Certified Professional Coder (CPC), Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS) or similar certification preferred.</li></ul></div><p></p><div><b><br>
Deadline for Application:</b> Open Until Filled</div><div></div><div><b><br>
How to Apply</b></div><div></div><div><br>
To be considered, submit your application and resume through our ADP Career Center. Your resume must include:</div><div></div><div><br>
<ul><li>
Employer name, dates of service (month/year), average hours worked per week, and essential job duties</li><li>
Education details (degree type, date awarded, institution, field of study)</li><li>
Licensure/certification information, if applicable</li></ul></div><div></div><div><br>
After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You&rsquo;ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.</div><div></div><div><br>
Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.</div><div></div><div><b><br>
Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.</b></div><div></div><div><i><br>
#Innovation #Technology #Careers #NorthCarolina #BehavioralHealth</i></div></div>

Senior Claims Specialist

<div></div><div><div>Primary Details</div>
Time Type: Full time<div></div>
Worker Type: Employee<div></div><div>
Senior Claims Specialist</div><ul><li><div>
Location: USA &ndash;Texas</div></li><li><div>
Work Arrangement: Remote</div></li><li><div>
The salary range for this role is: $88,000-132,000K</div></li></ul><div></div><div>
The Opportunity</div><div></div><div>
The purpose of this role is to provide exceptional claims service to customers by managing complex claims effectively. This includes assessing policy coverage, investigating, evaluating, and negotiating intricate claims, collaborating with suppliers and stakeholders, and offering senior technical guidance and support.</div><div></div><div>
Responsibilities:</div><ul><li>
Provide technical guidance and analysis for complex and high-value claims.</li><li>
Assist in implementing and maintaining claims management strategies.</li><li>
Maintain comprehensive knowledge of insurance guidelines and policies.</li><li>
Build and maintain relationships with stakeholders.</li><li>
Manage a portfolio of complex or high-value claims.</li><li>
Act as an escalation point for customer complaints.</li><li>
Provide senior technical expertise and mentoring for team development.</li><li>
Engage with the team to encourage partner relationships.</li><li>
Support process improvement through negotiation and dispute resolution.</li></ul><div></div><div>
Work Experience:</div><div></div><div>
Preferred Work Experience includes:</div><ul><li>
Relevant experience in classes.</li><li>
Management of complex and/or high value claims.</li><li>
Involvement with relevant industry groups</li></ul><div></div><div>
Qualifications:</div><div></div><div>
Preferred Qualifications include:</div><ul><li>
Tertiary Degree or equivalent combination of education and work experience.</li></ul><div></div><div>
Compensation Package: The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate&rsquo;s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE&rsquo;s annual discretionary bonus plan based on business and individual performance. We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team.</div><div></div><div>
QBE Benefits: We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to:</div><ul><li><div>
Hybrid Working &ndash; a mix of working from home and in the office</div></li></ul><ul><li><div>
22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis</div></li><li><div>
Competitive 401(k) program with company match up to 8%</div></li><li><div>
Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice</div></li><li><div>
Tuition Reimbursement for professional certifications, and continuing education</div></li><li><div>
Employee Network and Community &ndash; QBE actively supports six Employee Networks, and many ways to give back to your community</div></li></ul><div>
To learn more, click here: <div>Benefits | QBE US</div>.</div><div></div><div>
Why QBE? What if you could have a positive impact &ndash; at work and in the world?</div><div></div><div>
At QBE, we&rsquo;re enabling a more resilient future &ndash; for our customers, communities, environment, and for our people. We&rsquo;re building momentum to achieve something significant and know our people are at the center of our success.</div><div></div><div>
Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you&rsquo;ll get to spend every day working with people who are passionate, talented and kind. And our international scale means we&rsquo;re big enough for your ambitions, yet small enough for you to make a real impact.</div><div>
Join us now, so you can be part of our success &ndash; and we can be part of yours!</div><div><div>
https://www.linkedin.com/company/qbe-north-america/</div></div><div></div><div>
Commitment to Diversity</div><div>
QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information.</div><div></div><div>
Equal Employment Opportunity:</div><div>
QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.</div><div><div>
Supplementary information</div></div><div></div><div>
Skills:</div>
Analytical Thinking, Claims Settlement, Coaching, Critical Thinking, Detail-Oriented, Insurance Claims Management, Insurance Policies, Intentional collaboration, Managing performance, Problem Solving, Process Improvements, Regulatory Compliance, Risk Management, Stakeholder Management, Technical Support<div></div><div>
How to Apply:</div><div>
To submit your application, click &quot;Apply&quot; and follow the step by step process.</div><div></div><div>
Equal Employment Opportunity:</div><div>
QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.</div></div>

TrueNorth Companies

<div><p>TrueNorth is seeking a <b>Senior Claims Specialist</b> to join our Risk &amp; Workforce Solutions team, based in any of our office locations: Cedar Rapids, IA; West Des Moines, IA; Rosemont, IL; or Denver, CO. We use our core values of Exceptionalism, Collaboration and Resourcefulness to enthusiastically serve our clients, colleagues and communities. Our ideal candidates are <i>hungry, humble and smart!</i></p><p><b>
About TrueNorth Companies:</b></p><p>
Our clients face great risk and big opportunities. They seek leadership, integrity and real results. For twenty years, TrueNorth has met our clients' needs by providing innovative strategies and a personal connection to those we serve. Our integrated platform of risk management, employee benefits and personal financial strategies creates a multifaceted approach to address today's ever-changing complexities. Come join our amazing team!</p><p><b>
TrueNorth offers a lineup of excellent benefits to all full-time employees, including:</b></p><div><ul><li>
Annual Bonus</li><li>
Medical, Dental, Vision, Life, and Disability Insurance</li><li>
401(k) with Company Contributions</li><li>
Responsible Time Off (RTO): Flexible time off with a required minimum to ensure rest and balance, plus 11 paid holidays</li><li>
Paid Volunteer Time Off and Donation Match Program</li><li>
Tuition reimbursement and paid certifications, licenses, designations</li><li>
Employee Assistance Program (EAP) and wellness program with financial incentives</li><li>
Hybrid Work Schedule</li><li>
$3,000 Referral Bonus</li></ul></div><p>
The Senior Claims Specialist will support our Transportation clients, helping manage and resolve their claims while advocating for fair, timely outcomes with insurance carriers.</p><p><b>
Essential Job Functions:</b></p><div><ul><li>
Proactively communicate with clients and insurance carriers, providing regular updates on claim status and advocacy efforts.</li><li>
Assist clients across various industries in preparing accurate claims documentation and educating them on the claims process.</li><li>
Manage complex, severe, and catastrophic claims, collaborating with the loss prevention team to identify trends and recommend best practices.</li><li>
Review claim status, action plans, and reserves, leveraging claims expertise to achieve favorable outcomes for all parties involved.</li><li>
Provide recommendations to clients and insurance carriers on strategies to achieve superior claims outcomes.</li><li>
Develop and implement claims resolution processes and procedures to enhance efficiency and effectiveness.</li><li>
Facilitate claim reviews, engage in problem-solving techniques, and ensure transparency in expectations with clients.</li><li>
Perform research on policies, legal statutes, case law, and coverage details to determine appropriate coverage for claims.</li><li>
Complete onboarding of new clients and adjustments to existing insurance programs, ensuring awareness of claims requirements.</li><li>
Mentor team members and participate in ongoing training, while maintaining high standards of client service, including up to 30% travel.</li><li>
Perform other duties as assigned</li></ul></div><p><b>
Credentials:</b></p><div><ul><li>
High School diploma or GED required, two or four-year degree preferred.</li><li>
A two-year or four-year degree preferred.</li><li>
8 years of work experience in a claims role is required.</li><li>
Prior experience with multi-lines commercial claims is preferred, in addition to agency experience, and familiarity of litigation procedures, mediations and other ADR (Alternative Dispute Resolution) strategies</li><li>
Transportation experience preferred.</li><li>
AIC, or SCLA designations preferred.</li><li>
Commercial Property &amp; Casualty license not required at time of hire, but must be obtained within first 90 days of employment.</li></ul></div><p><b>
Skills:</b></p><div><ul><li>
Strong analytical skills with the ability to interpret and communicate data or statistical findings</li><li>
Ability to provide constructive support and positive feedback to encourage team growth</li><li>
Forward-thinking mindset to anticipate opportunities and potential challenges</li><li>
Ability to work independently with minimal direction</li><li>
Strong coaching and development skills to advise, guide, and train others</li></ul></div><p><b>
Why TrueNorth?</b></p><p>
We are a company focused on developing our people and growing the business. We offer a competitive benefit package, wellbeing programs and incentives, and a positive work culture.</p><p>
TrueNorth is honored to be recognized by the Corridor Business Journal as one of the Coolest Places to Work!</p><p>
Click here to view a video about TrueNorth's Core Values &amp; what they mean to us.</p><p>
TrueNorth makes all employment-related decisions on the basis of qualifications, merit, and business need, and does not discriminate against any applicant on the basis of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other category protected local, state or federal laws.</p><p>
Apply today!</p></div><p></p>

Senior Claims Specialist - Transportation

Mid Continent Casualty

<div><p>Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other industries. Mid-Continent Group provides a broad selection of General Liability, Commercial Auto, Inland Marine and Umbrella products.</p><p></p><p>
Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group, a Fortune 500 company, combines &ldquo;small company&rdquo; culture with &ldquo;big company&rdquo; expertise. Here, your ideas will be heard, and you&rsquo;ll have the support to succeed. With over 35 specialty and property and casualty operations, there are always opportunities to learn and grow.</p><p></p><p>
At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.</p><p></p><p>
Mid-Continent Group is currently seeking a Claims Specialist/Senior Claims Specialist to join our Claims Team. The position will work a hybrid schedule from downtown Tulsa, OK, or downtown Cincinnati, OH.</p><p></p><h2 class="jobSectionHeader"><b>
Essential Job Functions and Responsibilities</b></h2><ul><li><p>
Manage a portfolio of complex, high-value commercial general liability and auto claims across the U.S.</p></li><li><p>
Lead investigations, evaluate coverage and liability, and drive resolution strategies.</p></li><li><p>
Represent the company in mediations, depositions, and trials.</p></li><li><p>
Collaborate with underwriting and marketing teams to identify trends and improve outcomes.</p></li><li><p>
Serve as a technical expert and strategic advisor within your line of business.</p></li><li><p>
Ensure compliance with all legal and regulatory standards.</p></li><li><p>
Offer expert advice to other members of your team on complex claim file management and demonstrate leadership across the organization.</p></li></ul><p></p><h2 class="jobSectionHeader"><b>
Job Requirements</b></h2><ul><li><p>
9+ years of experience handling general liability and/or commercial auto claims.</p></li><li><p>
Strong analytical skills and deep understanding of policy coverage.</p></li><li><p>
Excellent communication, negotiation, and organizational abilities.</p></li><li><p>
Bachelor&rsquo;s degree in Business, Risk Management, Insurance, or related field (or equivalent experience).</p></li><li><p>
Professional designations (e.g., CPCU) are a plus.</p></li></ul><p></p><h2 class="jobSectionHeader"><b>
Ready to Make a Difference?</b></h2><p>
Join a team where your expertise is valued, your voice is heard, and your career can flourish. Apply today and be part of something great.</p><p></p><p><b>
Company:</b></p>
MCC Mid-Continent Casualty Company<p></p><p><b>
Benefits:</b></p><p>
We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits.</p><p></p><p><br>
Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Your recruiter will provide details about benefits and specific compensation ranges during the hiring process. Learn more at http://www.gaig.com/careers.</p><p></p><ul><li><br>
<b>Excludes seasonal employees and interns.</b></li></ul></div>

Claims Specialist/Senior Claims Specialist

Berkley

<div>Company Details:<div></div><div><br>
</div><p>Berkley Industrial Comp, formerly American Mining Insurance Group, began operating in 1989 as a specialty carrier offering workers compensation coverage to qualified mining and mining related accounts. Known for excellence in loss control, claims management and underwriting, Berkley Industrial Comp has remained focused on our mission as the company has grown and matured.</p><p></p><p><br>
Since becoming a W.R. Berkley Corporation member company in 2007, Berkley Industrial Comp has quadrupled its operating territory, introduced preferred rating plans, focused on continuous improvement in ease of doing business, made significant new investments in technology and added additional highly experienced staff to our team. With an AM Best rating of A+ Superior XV, Berkley Industrial Comp&rsquo;s commitment to the mining sector remains unwavering.</p><div></div><div><br>
https://www.berkleyindustrial.com</div><div></div><div><br>
The company is an equal opportunity employer.</div>
Responsibilities:
<p>
This position is responsible for managing both lost time and med only claims across multiple jurisdictions up to $250,000 in exposure. This includes investigation, evaluation, and resolution of claims. Interface with underwriting, risk management, case management, clients, and vendors as appropriate in controlling costs and loss ratios and providing the claimant with appropriate care. Provide leadership within the claims department.</p><p></p><p><br>
Key functions include but are not limited to the following:</p><br>
<p></p><ul><li>
Oversee catastrophic and large loss claims from beginning to resolution.</li><li>
Manage all technical aspects of claims including coverage, disability benefit management, medical management, file management, litigation management, subrogation, reserving and settlement.</li><li>
Verify and interpret coverage issues.</li><li>
Consult with attorneys, assist in negotiation of settlement, mediations and trials (attend trials as necessary).</li><li>
Resolve problems involving multi-faceted claims handling.</li><li>
Investigate, evaluate, and negotiate claims toward resolution and provide medical needs within jurisdictional guidelines and Berkley Industrial Comp philosophies.</li><li>
Determinate appropriate reserves to adequately reflect exposure of losses.</li><li>
Attend and participate in training sessions to the accounts or account visits and claim reviews.</li></ul>
Qualifications:
<ul><li>Bachelor&rsquo;s degree with concentration in criminal justice, public administration, business, nursing or insurance OR equivalent work experience.</li><li>
Experience across multiple jurisdictions preferred.
</li><li>Five (5) years&rsquo; minimum of experience adjusting workers&rsquo; compensation claims with significant experience handling Workers&rsquo; Compensation claims. Ten (10) years&rsquo; experience preferred.
</li><li>Possess and maintain a professional adjusting license in all jurisdictions applicable or obtained within one year of job acceptance.
</li><li>Strong interpersonal, analytical, and negotiation skills.</li><li>
The Company is an equal employment opportunity employer.</li></ul>
Additional Company Details: We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Sponsorship Details: Sponsorship not Offered for this Role</div>

CorVel Corporation

<div><p>We are seeking a 4850 Sr. Claims Specialist for our Southern California Team. The Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel.</p>
<p>
We are open to remote work. Candidates must reside in California.</p><br>
<p></p>
<p><b>
ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:
</b></p><ul><li>Receives claim, confirms policy coverage and acknowledgement of the claim</li>
<li>Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies</li>
<li>Establishes reserves and authorizes payments within reserving authority limits</li>
<li>Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim</li>
<li>Coordinates early return-to-work efforts with the appropriate parties</li>
<li>Manages subrogation and litigation of claim as it applies</li>
<li>Manages potential claim recoveries of all types</li>
<li>Reports claims to the excess carrier when applicable</li>
<li>Communicates claim status with the customer and claimant</li>
<li>Adheres to client and carrier guidelines and participates in claims review as needed</li>
<li>Develops and maintains professional customer relationships</li>
<li>Complies with rules and regulations of applicable state</li>
<li>Additional projects and duties as assigned</li></ul><br>
<p></p>
<p><b>
KNOWLEDGE &amp; SKILLS:
</b></p><ul><li>Excellent written and verbal communication skills</li>
<li>Ability to assist team members to develop knowledge and understanding of claims practice</li>
<li>Ability to identify, analyze and solve problems</li>
<li>Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets</li>
<li>Strong interpersonal, time management and organizational skills</li>
<li>Ability to work both independently and within a team environment</li>
<li>Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers&rsquo; Compensation</li></ul><br>
<p></p>
<p><b>
EDUCATION &amp; EXPERIENCE:
</b></p><ul><li>Bachelor's degree or a combination of education and related experience</li>
<li>4-5 years of California Workers&rsquo; Compensation claims handling experience required</li>
<li>CA workers compensation adjuster license required</li>
<li>Associates in Claims or Associates in Risk Management designation preferred</li>
<li>4850 experience required</li></ul><br>
<p></p>
<p><b>
PAY RANGE:</b></p>
<p>
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.</p>
<p>
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.</p>
<p>
Pay Range: $29.35 - $47.28 per hour</p>
<p>
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management</p>
<p>
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.</p><br>
<p></p>
<p><b>
About CorVel
</b></p><p>CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; 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!).</p>
<p>
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.</p>
<p><b>
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.</b></p>
<p>
#LI-Remote</p></div>

CA WC Senior Claims Specialist (SIP) 4850

<div><p>The Senior Claims Indemnity 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.</p>
<p>
This is a remote position.</p>
<p><b>
ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:</b></p>
<ul>
<li>Receives claim, confirms policy coverage and acknowledgement of the claim</li>
<li>Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies</li>
<li>Establishes reserves and authorizes payments within reserving authority limits</li>
<li>Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim</li>
<li>Coordinates early return-to-work efforts with the appropriate parties</li>
<li>Manages subrogation and litigation of claim as it applies</li>
<li>Manages potential claim recoveries of all types</li>
<li>Reports claims to the excess carrier when applicable</li>
<li>Communicates claim status with the customer and claimant</li>
<li>Adheres to client and carrier guidelines and participates in claims review as needed</li>
<li>Develops and maintains professional customer relationships</li>
<li>Complies with rules and regulations of applicable state</li>
<li>Additional duties as assigned</li></ul><br>
<p></p>
<p><b>
KNOWLEDGE &amp; SKILLS:</b></p>
<ul>
<li>Excellent written and verbal communication skills</li>
<li>Ability to assist team members to develop knowledge and understanding of claims practice</li>
<li>Ability to identify, analyze and solve problems</li>
<li>Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets</li>
<li>Strong interpersonal, time management and organizational skills</li>
<li>Ability to work both independently and within a team environment</li>
<li>Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers&rsquo; Compensation</li></ul><br>
<p></p>
<p><b>
EDUCATION &amp; EXPERIENCE:</b></p>
<ul>
<li>Bachelor's degree or a combination of education and related experience</li>
<li>Minimum of 3 years&rsquo; industry experience and claim handling</li>
<li>Self-Insured Certificate preferred</li>
<li>State Certification as an experienced Examiner</li></ul><br>
<p></p>
<p><b>
PAY RANGE:</b></p>
<p>
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.</p>
<p>
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.</p>
<p>
Pay Range: $59,681 &ndash; $96,123</p>
<p>
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management</p>
<p>
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.</p><br>
<p></p>
<p><b>
ABOUT CORVEL:</b></p>
<p>
CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; 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!).</p>
<p>
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.</p>
<p><b>
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.</b></p>
<p>
#LI-Remote</p></div>

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