Florida Workers' Compensation Senior Claims Specialist

The Senior 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.This is a hybrid position.ESSENTIAL FUNCTIONS & RESPONSIBILITIES:Receives claim, confirms policy coverage and acknowledgement of the claimDetermines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agenciesEstablishes reserves and authorizes payments within reserving authority limitsDevelops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claimCoordinates early return-to-work efforts with the appropriate parties.Manages subrogation and litigation of claim as it appliesManages potential claim recoveries of all typesReports claims to the excess carrier when applicableCommunicates claim status with the customer and claimantAdheres to client and carrier guidelines and participates in claims review as neededDevelops and maintains professional customer relationshipsComplies with rules and regulations of applicable stateAdditional projects and 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 MS Office including Excel spreadsheetsStrong interpersonal, time management and organizational skills.Ability to work both independently and within a team environmentKnowledge 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 handlingSelf-Insured Certificate preferredState Certification as an experienced ExaminerBilingual in English and SpanishPAY 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.Pay Range: $59,681 - $96,123A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk ManagementIn 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 CorVelCorVel, 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.#LI-Hybrid

Created: 2025-02-17