CA Senior Claims Specialist

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel .

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

ReceivesWorkers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the appropriate parties Manages subrogation and litigation of claim as it applies Manages potential claim recoveries of all types Reports claims to the excess carrier when applicable Communicates claim status with the customer and claimant Adheres to client and carrier guidelines and participates in claims review as needed Develops and maintains professional customer relationships Complies with rules and regulations of applicable state Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”) Additional duties as assigned