CorVel - Downers Grove, IL

posted 24 days ago

Full-time - Entry Level
Downers Grove, IL
1,001-5,000 employees
Professional, Scientific, and Technical Services

About the position

The Claims Specialist is responsible for managing lower-level, non-complex Medical Only workers' compensation claims and more complex Lost Time claims. This role operates within company best practices and delegated authority, aiming for the best possible outcomes under the supervision of a senior claims professional. The position supports the goals of the claims department and CorVel, ensuring effective communication and adherence to guidelines.

Responsibilities

  • Receives claims, confirms policy coverage and acknowledgment of the claim
  • Determines validity and compensability of the claim
  • Establishes reserves and authorizes payments within reserving authority limits
  • Manages non-complex and non-problematic medical only claims and more complex, lost-time workers' compensation claims
  • Communicates claim status with the customer, claimant and client
  • Adheres to client and carrier guidelines and participates in claims review as needed
  • Requires regular and consistent attendance
  • Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (IIPP)
  • Completes additional projects and duties as assigned

Requirements

  • Bachelor's degree or a combination of education and related experience
  • Minimum of 3 years of industry experience and claims management preferred
  • Excellent written and verbal communication skills
  • Ability to learn rapidly 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 spreadsheets
  • Strong interpersonal, time management and organizational skills
  • Ability to meet or exceed performance competencies
  • Ability to work both independently and within a team environment

Benefits

  • Medical (HDHP) with 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
  • Paid time off
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