What are the responsibilities and job description for the Medical Only Claims Specialist position at CorVel Corporation?
Description
CorVel in Las Vegas, NV is seeking a full time Medical Only Claims Specialist. The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
- Receives claims, confirms policy coverage and acknowledgement of the claim
- Determines the validity and compensability of the claim
- Establishes reserves and authorizes payments within established reserving authority limits
- Manage non-complex and non-problematic medical-only claims under close supervision
- Communicates claim status with the customer, claimant and client.
- Adheres to client and carrier guidelines and participates in claims review as needed.
- Assists other claims professionals with more complex or problematic claims as necessary.
- Requires regular and consistent attendance.
- Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
- Additional projects and duties as assigned.
KNOWLEDGE & SKILLS:
- Excellent Customer Service Skills
- Excellent written and verbal communication skills.
- PC literate, including Microsoft Office (Word, Excel)
- Ability to learn rapidly to develop knowledge and understanding of claims practice, relevant statutes and medical terminology.
- Ability to identify, analyze and solve problems.
- Strong interpersonal, time management and organizational skills.
- Ability to work both independently and within a team environment.
- Ability to meet or exceed performance competencies
EDUCATION/EXPERIENCE:
- Bachelor's degree or a combination of work experience preferred
- Minimum of 1 year industry experience and claim handling
- NV WC experience required
- NV Workers Compensation Adjusters license required
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable
About CorVel
CorVel, 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 publically 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 3500 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.