WC Claims Examiner
Corvel Corporation 138 reviews - Largo, MD

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Manage 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.

Essential Job Duties:
1. Receives claim, confirms policy coverage and acknowledgement of the claim 2. Determine validity and compensability of the claim by investigating and gathering information regarding the claim and the file necessary documentation with the state agencies 3. Establish reserves and authorize payments within reserving authority limits 4. Develop and manage well documented action plan with the case manager, attorney, supervisor and client to reduce overall cost of the claim 5. Coordinating early return-to-work efforts with the case manager and employer 6. Negotiates settlements when necessary 7. Actively manage the litigation process 8. Identifies potential subrogation claims 9. Communicate claim status with the customer and claimant 10. Adhere to client guidelines and participate in claims review as needed develops and maintains professional customer relationships

Education/Training Requirements:
Knowledge & Skills 1. Excellent oral and written communication skills 2. PC literate, including Microsoft Office (Word, Excel) 3. Effective analytical and interpretive skills 4. Strong organizational skills 5. Great interpersonal skills 6. Ability to work in a team environment 7. Ability to work independently 8. Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation 9. Thorough knowledge of appropriate insurance principles and laws for workers’ compensation recoveries and offsets Education Four year degree at an accredited college or university preferred Experience Three (3) years of Workers' Compensation claims management experiences required.

About this company
138 reviews
CorVel is a leader of risk and healthcare management solutions to employers, third party administrators, insurance companies and government...