Senior Claims Resolution Architect

CorVel Corporation

Charleston, WV 25305

CorVel Senior Claims Specialist – West Virginia

Location: West Virginia | Role: Senior Claims Specialist | Work Type: 100% Remote

The Senior Claims Specialist at CorVel is responsible for managing complex and high-visibility workers’ compensation claims in West Virginia. This role involves working within company standards and best practices to determine benefits due, collaborating with case managers and attorneys, managing subrogation, and negotiating settlements to ensure optimal customer service and claim outcomes.

Essential Functions & Responsibilities:

  • Receive claims, confirm policy coverage, and acknowledge claims
  • Determine validity and compensability through investigation and information gathering
  • Establish reserves and authorize payments within authority limits
  • Develop and manage action plans with case and outcomes managers to reduce overall claim costs
  • Coordinate early return-to-work efforts with relevant parties
  • Manage subrogation, litigation, and potential recoveries
  • Report claims to excess carrier when applicable
  • Communicate claim status with customers and claimants
  • Adhere to client and carrier guidelines, participate in claims reviews
  • Develop and maintain professional customer relationships
  • Comply with rules and regulations of applicable state
  • Additional projects and duties as assigned

Knowledge & Skills:

  • Excellent written and verbal communication skills
  • Ability to assist team members in developing knowledge of claims practice
  • Problem identification, analysis, and resolution skills
  • Computer proficiency with MS Office, including Excel
  • Strong interpersonal, time management, and organizational skills
  • Ability to work independently and within a team environment
  • Knowledge of entire claims administration, case management, and cost containment applicable to Workers’ Compensation

Education/Experience:

  • Bachelor’s degree or equivalent education and experience
  • Minimum of 3 years’ industry experience and claim handling
  • Self-Insured Certificate preferred
  • State Certification as an experienced Examiner

Pay Range:

$56,860 – $91,580

About CorVel:

CorVel, a certified Great Place to Work® Company, is a national provider of risk management solutions. Founded in 1987, publicly traded on NASDAQ since 1991, CorVel invests in human capital and technology to deliver innovative solutions. With over 4,000 employees, we embrace core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT!).

Benefits:

Comprehensive benefits package for full-time regular employees, including Medical, Dental, Vision, Long Term Disability, 401K, and more.

Equal Opportunity Employer | Drug-Free Workplace | ADA Compliant

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