JOB SUMMARY:The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim, supporting the goals of claims department and of CorVel. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claimDetermines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agenciesEstablishes reserves and authorizes payments within reserving authority limitsDevelops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claimCoordinates early return-to-work efforts with the appropriate parties.Manages subrogation and litigation of claim as it appliesManages potential claim recoveries of all typesReports claims to the excess carrier when applicableCommunicates claim status with the customer and claimantAdheres to client and carrier guidelines and participates in claims review as neededDevelops and maintains professional customer relationshipsComplies with rules and regulations of applicable stateAdditional projects and duties as assigned.KNOWLEDGE & SKILLS:Excellent written and verbal communication skills.Ability to assist team members 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 spreadsheetsStrong interpersonal, time management and organizational skills.Ability to work both independently and within a team environment.Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation.EDUCATION/EXPERIENCE:Bachelor's degree or a combination of education and related experience.Minimum of 5 years' industry experience and claim handling#cb *mon*