Talent.com
CA Claims Specialist

CA Claims Specialist

CorVelMiami, FL, US
1 day ago
Job type
  • Full-time
Job description

CA Claims Specialist

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote position.

Essential Functions & 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 minor lost-time workers' compensation 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
  • Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program ("IIPP")
  • Additional projects and duties as assigned

Knowledge & Skills :

  • 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
  • Education & Experience :

  • Bachelor's degree or a combination of education and related experience
  • Minimum of 1 year of industry experience and claims management preferred
  • State Certification as an Experienced Examiner
  • Pay Range : $24.91 - $40.17 per hour

    CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors : federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

    For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

    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.

    CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

    Create a job alert for this search

    Claim Specialist • Miami, FL, US

    Related jobs
    Claims Examiner II

    Claims Examiner II

    DOCTORS HEALTHCARE PLANS, INC.Coral Gables, FL, US
    Full-time
    Quick Apply
    The Claims Examiner is responsible for providing expertise and / or claims support in reviewing, researching, investigating, processing and adjusting claims and other duties as necessary.Review, rese...Show moreLast updated: 30+ days ago
    • Promoted
    Commercial Billing Specialist / Job ID : 1603568

    Commercial Billing Specialist / Job ID : 1603568

    Florida Physician Group IncHialeah, FL, US
    Full-time
    Under the direction of the Directors or designee, the Billing Specialist ensures all Commercial / Managed Care, Medicare and Medicaid claims are reviewed for claim edits, claim submission, and time...Show moreLast updated: 30+ days ago
    • Promoted
    Claims Examiner II

    Claims Examiner II

    Doctors Healthcare Plans, Inc.Miami, FL, US
    Full-time
    The Claims Examiner is responsible for providing expertise and / or claims support in reviewing, researching, investigating, processing and adjusting claims and other duties as necessary.Review, rese...Show moreLast updated: 30+ days ago
    • Promoted
    Account Specialist

    Account Specialist

    Robert HalfMiami, FL, US
    Temporary
    We are looking for a detail-oriented Account Specialist to join our team in Miami, Florida.In this role, you will provide comprehensive account management support to a variety of customers, includi...Show moreLast updated: 30+ days ago
    • Promoted
    Billing Specialist

    Billing Specialist

    Solomon Search GroupMiami, FL, US
    Full-time
    Quick Apply
    The Miami office of a national law firm, seeks a Billing Specialist to help with client bills, follow up on overdue accounts, and support the attorneys and accounting team.The Billing Specialist wi...Show moreLast updated: 30+ days ago
    • Promoted
    Open Enrollment Specialist

    Open Enrollment Specialist

    USHEALTHMiami Beach, FL, US
    Full-time
    You'll work directly with Americas self-employed, small business owners and individuals to help them access a product suite of affordable benefits and business services. Our clients are looking for ...Show moreLast updated: 13 days ago
    • Promoted
    Claims Specialist

    Claims Specialist

    ApTaskMiami, FL, US
    Full-time
    Top 5 Required Skills : Strong Basic Math Skills, Critical Reasoning / Thinking, Attention to Detail, Ability to Follow Procedures, Good Verbal and Written Communication Remote / Onsite : Remote, Bring Y...Show moreLast updated: 1 day ago
    • Promoted
    Seeking Claims Adjusters!Fort Lauderdale, Florida, United States

    Seeking Claims Adjusters!Fort Lauderdale, Florida, United States

    Morgan & Morgan, P.A.Fort Lauderdale, FL, US
    Full-time
    At Morgan & Morgan, the work we do matters.For millions of Americans, we're their last line of defense against insurance companies, large corporations or defective goods. From attorneys in all 50 st...Show moreLast updated: 30+ days ago
    • Promoted
    Commercial Billing Specialist / Job ID : 1603572

    Commercial Billing Specialist / Job ID : 1603572

    Florida Physician Group IncHialeah, FL, US
    Full-time
    Under the direction of the Directors or designee, the Billing Specialist ensures all Commercial / Managed Care, Medicare and Medicaid claims are reviewed for claim edits, claim submission, and time...Show moreLast updated: 30+ days ago
    • Promoted
    Senior On-Site Service Specialist.Managed Services Onsite

    Senior On-Site Service Specialist.Managed Services Onsite

    Metasys TechnologiesMiami Beach, FL, US
    Temporary
    Candidates who receive an offer will be required to successfully complete a background check and drug test as a condition of employment. The Office Support Associate will be responsible for providin...Show moreLast updated: 27 days ago
    • Promoted
    Commercial Billing Specialist

    Commercial Billing Specialist

    Florida Physician Group IncHialeah, FL, United States
    Full-time
    Under the direction of the Directors or designee, the Billing Specialist ensures all Commercial / Managed Care, Medicare and Medicaid claims are reviewed for claim edits, claim submission, and time...Show moreLast updated: 3 days ago
    • Promoted
    Claims Analyst

    Claims Analyst

    LennarMiami, FL, US
    Full-time
    Lennar Corporate Risk Management Position.Lennar is one of the nation's leading homebuilders, dedicated to making an impact and creating an extraordinary experience for their Homeowners, Communitie...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    East Florida Division Claims Administrator

    East Florida Division Claims Administrator

    Nashville StaffingMiami, FL, US
    Full-time
    East Florida Division Claims Administrator.Do you want to join an organization that invests in you as a East Florida Division Claims Administrator? At HCA Healthcare, you come first.HCA Healthcare ...Show moreLast updated: 15 hours ago
    Claims Specialist, Audit & Contracting

    Claims Specialist, Audit & Contracting

    LogixHealth, Inc.Dania Beach, Florida, United States, 33004
    Full-time
    At LogixHealth we provide expert coding and billing services that allow physicians to focus on providing great clinical care. LogixHealth was founded in the 1990s by physicians to service their own ...Show moreLast updated: 9 days ago
    • Promoted
    Claims Adjudicator

    Claims Adjudicator

    National Healthcare Solutions, Inc.Miami, FL, US
    Full-time
    We are a dynamic enterprise group of managed care and health insurance service companies which have become industry leaders in their diverse specialties. Headquartered in Dallas, Texas, the group ha...Show moreLast updated: 5 days ago
    • Promoted
    Cash Application Specialist

    Cash Application Specialist

    Vaco by HighspringMiami, FL, US
    Full-time
    Accounts Receivable – Cash Applications Specialist.Temp to Hire | Onsite – Miami, FL.We’re currently partnering with a well-established company in. Accounts Receivable Cash Applications Specialist.A...Show moreLast updated: 22 days ago
    • Promoted
    Travel CT Technologist - $1,654 per week

    Travel CT Technologist - $1,654 per week

    Skyline Med Staff AlliedHomestead, FL, United States
    Full-time
    Skyline Med Staff Allied is seeking a travel CT Technologist for a travel job in Homestead, Florida.Job Description & Requirements. Join the Top- Rated Travel Healthcare Team!.Skyline Med Staff was ...Show moreLast updated: 1 day ago
    • Promoted
    Insurance Collection Specialist

    Insurance Collection Specialist

    MedixMiami, FL, United States
    Permanent
    You are applying for a position through Medix, a staffing agency.The actual posting represents a position at one of our clients. Manage insurance denials by reviewing billed and denied accounts.Anal...Show moreLast updated: 3 days ago