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Claims Specialist - Medical Only

Posted on Aug 11, 2019 by CorVel Corporation

Portland, OR 97201
Health Care
Immediate Start
Annual Salary
Full-Time

CorVels Oregon office is excited to announce that we are looking to add an addition to our claims team and have an opportunity for a Workers Compensation Claim Specialist - Medical Only.

This role will manage, within company standards and best practices, medical only Washington and Oregon workers' compensation claims within the delegated limited authority to determine benefits due. While working closely with clients and case managers, manage specific customer service requirements to achieve the best possible outcome in the claim.

Duties

  • Receives claim, confirms coverage and acknowledgment of the claim.
  • Determine validity and compensability of the claim by investigating and gathering information regarding the claim and the file necessary documentation with the State of Washington and/or Oregon.
  • Establish reserves and authorize payments within reserving authority limits.
  • Develop and manage a well-documented action plan with the case manager, supervisor, and client to reduce the overall cost of the claim.
  • Coordinating early return-to-work efforts with the case manager and employer
  • Identifies potential subrogation claims.
  • Communicate claim status with the customer and claimant.
  • Adhere to client guidelines and participate in claims review as needed.
  • Develops and maintains professional customer relationships.

Knowledge & Skills

  • Knowledge of the entire claims administration, case management, and cost containment solution as applicable to Workers Compensation for the State of Washington and/or Oregon.
  • Washington and/or Oregon claims management experience required.
  • Effective analytical and interpretive skills.
  • Great interpersonal skills with the ability to work independently and in a team environment.
  • Excellent oral and written communication skills.

All candidates must be eligible to work in the United States without VISA sponsorship

We are an Equal Opportunity Employer. All persons shall have the opportunity to be considered for employment without regard to their race, color, age, sex, gender, religion, national origin, ancestry, citizenship status, physical or mental disability, military service, veteran status or any other characteristic protected by applicable federal, state or local law.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this application or to participate in an interview, please let us know.

Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes.

Please be aware that CorVel generally does not review all applications/resumes submitted in response to job openings posted on the Internet because of the large volume of responses

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Reference: 744308123

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