The specialist analyzes and monitors claims audit data to ensure accurate reimbursement for healthcare providers. Key duties include identifying payment variances, repricing claims according to contracts, and producing statistical reports on revenue cycle data.
CorVel Corporation
84 Remote Job Openings at CorVel Corporation
Senior Workers' Compensation Claims Specialist
CorVel Corporation
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Full Time
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3 days ago
CorVel Corporation
Manage complex and high-profile Workers' Compensation claims, including investigating validity, establishing reserves, and negotiating settlements. Coordinate with case managers and attorneys to develop action plans that reduce claim costs and ensure early return-to-work efforts.
The coordinator provides administrative support by scheduling ancillary healthcare appointments for claimants and providers. This involves managing high-volume inbound and outbound calls while ensuring all stakeholders are updated regularly.
The analyst is responsible for verifying provider information and requesting documentation such as medical records and itemized bills to audit claims. They must ensure the accuracy of patient and client data while maintaining strict confidentiality of PHI and PII.
Provide telephonic first aid and treatment recommendations to injured workers using national triage protocols. Document clinical assessments and communicate care plans to customers and supervisors.
The Account Executive is responsible for selling new services, managing executive-level client relationships, and increasing market share. Key duties include conducting sales calls, managing opportunities in Salesforce, and responding to RFPs.
The Account Executive is responsible for selling new services, managing executive-level client relationships, and increasing market share. Key duties include conducting sales calls, managing opportunities in Salesforce, and responding to RFPs.
Provide vocational rehabilitation and medical case management to help injured workers return to gainful employment. Coordinate with clients, insurers, physicians, and employers to evaluate disability and determine suitable job goals.
CA Senior Claims Specialist - Temporary
CorVel Corporation
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Full Time
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6 days ago
CorVel Corporation
Manage complex and high-profile Workers' Compensation claims by investigating validity, establishing reserves, and negotiating settlements. Coordinate with case managers and attorneys to develop action plans that reduce claim costs and ensure early return-to-work efforts.
The Senior Advisor conducts executive-level assessments of managed care and workers' compensation programs to identify performance gaps and cost drivers. They translate complex data into actionable strategic recommendations and presentations for executive stakeholders.
Payment Integrity Analyst III - Trainer
CorVel Corporation
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Full Time
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7 days ago
CorVel Corporation
Leads the Policy and Payment Integrity team by reviewing pre and post-pay claim audits based on CMS and industry guidelines. Oversees team quality, provides training, and performs internal audits and appeals to ensure claim accuracy.
Payment Integrity Analyst III - QA Analyst
CorVel Corporation
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Full Time
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7 days ago
CorVel Corporation
Leads the Policy and Payment Integrity team by reviewing pre and post-pay claim audits for accuracy based on client and CMS guidelines. Oversees team productivity, conducts quality assurance reviews, and implements best practices for payment policies.
Develop and implement a comprehensive content marketing strategy to drive brand awareness and customer engagement. Manage the company's LinkedIn presence and create high-quality materials such as blog posts, white papers, and case studies.
Support key security, risk, and compliance functions, including third-party risk management and vendor security assessments. Assist in the preparation and coordination of regulatory audits such as SOC and HITRUST.
Supervise a team of Workers' Compensation claims staff to ensure quality, productivity, and compliance with regulatory requirements. Act as a liaison for clients and provide technical guidance on complex compensability and litigation issues.
The Telehealth Coordinator Lead manages client and provider inquiries while providing daily guidance and leadership to an assigned team. Key duties include reviewing medical notes, managing work queues, and recommending process improvements for workflow efficiency.
Directs the day-to-day operations of a designated department, overseeing human resources, customer service, and quality of service. Responsibilities include managing employees, reviewing operational reports, and providing clinical oversight for case management activities.
CA Claims Specialist - Bilingual (Spanish)
CorVel Corporation
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Full Time
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14 days ago
CorVel Corporation
Manage lower-level, non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. Communicate claim status to customers, claimants, and clients while adhering to carrier guidelines.
The Intake Specialist provides administrative customer service by receiving and entering new ancillary healthcare referrals into proprietary systems. They manage inbound and outbound communications to ensure service orders are processed with accuracy and urgency.
Provide advanced technical support for proprietary software by diagnosing and resolving complex application issues via ServiceNow. Act as a subject-matter expert to identify root causes and maintain technical documentation for system enhancements.
The Senior Claims Specialist manages complex Workers' Compensation claims, including investigating validity, establishing reserves, and negotiating settlements. They collaborate with case managers and attorneys to reduce claim costs and ensure high customer service standards.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
The representative handles client and provider inquiries via email, phone, and written correspondence while adhering to contractual and state guidelines. Key tasks include reviewing provider history in internal systems and maintaining reports and spreadsheets.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
The role involves researching and recommending secure technical solutions and partnering with engineering teams to threat model designs. It also focuses on maturing vulnerability management processes and conducting various risk assessments to protect corporate digital assets.
Telephonic Case Manager I - Columbia, SC
CorVel Corporation
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Full Time
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21 days ago
CorVel Corporation
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
The Intake Specialist provides administrative customer service by receiving and entering new ancillary healthcare referrals into proprietary systems. They manage inbound and outbound communications to ensure service orders are processed accurately and urgently for claimants and providers.
Certified Medical Coder I (Professional Review Specialist I)
CorVel Corporation
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Full Time
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25 days ago
CorVel Corporation
Analyze medical services and billing across various claim types to evaluate charge accuracy and medical necessity. Document final conclusions in proprietary systems and communicate specific concerns to claims examiners or managers.
The Senior Claims Specialist manages complex Workers' Compensation claims, including investigating validity, establishing reserves, and negotiating settlements. They collaborate with case managers and attorneys to reduce claim costs and ensure optimal outcomes for customers and the company.
The analyst is responsible for auditing and data-entry of medical bills to ensure adherence to state fee schedules and customer guidelines. The role involves reviewing bills for multiple states and lines of business while maintaining high accuracy and keystroke speed.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
Lead and mentor a 24/7 National Help Desk team to deliver exceptional tier-one support and operational excellence. Drive the adoption of modern technologies, specifically AI-driven solutions, to improve efficiency and customer experience.
Provides staff support to medical case managers to facilitate individualized treatment goals and return-to-work plans. Responsibilities include typing reports, transcribing dictation, organizing client files, and providing customer support.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Collaborates with physicians, patients, and payers to evaluate treatment appropriateness and implement medical recommendations.
The Claims Specialist manages low to mid-level auto and general liability claims, including bodily injury and property damage. Responsibilities include confirming policy coverage, establishing reserves, and communicating claim status to customers and clients.
Manages non-complex medical-only workers' compensation claims by confirming coverage and determining compensability. Responsible for establishing reserves, authorizing payments, and communicating claim status to customers and clients.
The Itemization Review Nurse analyzes medical facility charges on UBIB submissions to ensure billing accuracy. They document final conclusions in designated software and provide summaries of billed items.
The UR Intake Specialist handles precertification requests and manages incoming calls to support the Utilization Review and Case Management department. Responsibilities include verifying patient and provider information and entering service requests into the CareMC system.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
The Intake Specialist provides administrative customer service by receiving and entering new ancillary healthcare referrals into proprietary systems. They manage inbound and outbound calls and ensure case stakeholders are updated regularly to prevent scheduling delays.
The coordinator provides administrative customer service by scheduling ancillary healthcare appointments for claimants and providers. They are responsible for managing high-volume inbound and outbound calls while ensuring accurate data entry and stakeholder updates.
Manage lower-level, non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. Communicate claim status to customers, claimants, and clients while adhering to carrier guidelines.
Identify subrogation potential for workers' compensation and property/auto claims and negotiate settlements with insurance carriers and attorneys. Manage a queue of 250-300 claims while maintaining professional relationships with stakeholders and adhering to client guidelines.
Supervise a team of Workers' Compensation claims staff to ensure quality, productivity, and compliance with regulatory requirements. Provide technical guidance on complex claims and act as a liaison for clients and employees regarding claim resolutions.
The Provider Management Analyst verifies provider and patient information to audit claims and request necessary medical documentation. They are responsible for maintaining production standards and ensuring the strict confidentiality of PHI and PII.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
The analyst is responsible for conducting pre- and post-pay claim audits based on client policies and CMS guidelines. This includes reviewing itemized bills and DRG validations while providing professional written communication for audits and appeals.
Manages mid to complex Auto and General Liability claims, including bodily injury and property damage. Responsibilities include investigating claims, establishing reserves, and handling litigated files to achieve optimal outcomes.
Senior New England Claims Specialist
CorVel Corporation
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Full Time
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2 months ago
CorVel Corporation
Manage complex and high-profile Workers' Compensation claims by investigating validity, establishing reserves, and coordinating return-to-work efforts. Collaborate with case managers and attorneys to negotiate settlements and manage subrogation to reduce overall claim costs.
Manages non-complex medical-only workers' compensation claims by confirming coverage and determining compensability. Responsibilities include establishing reserves, authorizing payments, and communicating claim status to customers and clients.
Manage lower-level, non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. Communicate claim status to customers, claimants, and clients while adhering to carrier guidelines.
Senior Corporate Paralegal - Contracts
CorVel Corporation
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Full Time
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2 months ago
CorVel Corporation
The Senior Corporate Paralegal prepares, reviews, and negotiates a high volume of customer-facing and corporate agreements. They partner with internal stakeholders to manage the contract lifecycle and drive process efficiency through standardized templates and workflows.
Directs the day-to-day operations of a designated department, overseeing human resources, customer service, and clinical case management activities. Responsible for ensuring quality of service and managing reports, invoices, and limited sales activities.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
Customer Service Representative I - Workers' Compensation Call Center
CorVel Corporation
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Full Time
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2 months ago
CorVel Corporation
Manage inbound and outbound calls to support the Workers' Compensation department and assist claim adjusters. Document interactions and provide accurate claim information to claimants and internal teams.
Coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and return to work. Communicates with physicians, patients, and adjusters to evaluate treatment appropriateness and recommend alternative care options.
Senior Liability Claims Specialist Floater
CorVel Corporation
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Full Time
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2 months ago
CorVel Corporation
Provide temporary claims handling coverage for various clients, focusing on litigated Auto and General Liability files. Responsibilities include confirming coverage, determining liability, establishing reserves, and communicating status to stakeholders.
The Utilization Review Nurse evaluates clinical information for inpatient and outpatient admissions to certify medical necessity and determine appropriate lengths of stay. They also communicate with stakeholders, document all review activities, and ensure compliance with safety and regulatory standards.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, families, and medical providers. They are responsible for assessing treatment plans for medical necessity and cost-effectiveness while conducting regular in-person visits.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, physicians, and employers. Responsibilities include conducting in-person and telephonic assessments, evaluating treatment plans for medical necessity, and managing local travel to provider and home visits.
The Claims Specialist manages non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. They also communicate claim status to customers and clients while adhering to company and carrier guidelines.
The Claims Specialist manages non-complex workers' compensation claims by determining validity, establishing reserves, and authorizing payments. They also communicate claim status to customers and clients while adhering to established guidelines.
The Field Case Manager provides in-person and telephonic medical case management to injured workers to facilitate their recovery and ensure appropriate care. They collaborate with patients, families, and medical providers to develop effective treatment plans while managing cost-effectiveness and local travel requirements.
Utilization Review Case Management Supervisor
CorVel Corporation
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Full Time
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3 months ago
CorVel Corporation
The Case Management Supervisor directs daily operations, manages human resources, and ensures quality service for their department. They may also oversee clinical activities, perform reporting reviews, and engage in limited marketing or sales tasks.
Design, build, and deploy scalable machine learning models and data products to support enterprise initiatives. Collaborate with engineering and product teams to integrate these solutions into production environments using cloud platforms.
The Senior Claims Specialist manages complex Workers' Compensation claims by determining validity, establishing reserves, and coordinating return-to-work efforts. They also handle subrogation, litigation, and maintain professional relationships with customers and claimants.
The Medical Case Manager facilitates the recovery of injured workers by coordinating care between patients, families, physicians, and employers. Responsibilities include conducting in-person and telephonic assessments, evaluating treatment plans for medical necessity, and attending medical or legal appointments.
The Claims Supervisor manages a team of workers' compensation staff to ensure quality, productivity, and regulatory compliance. They also assist with recruitment, training, and providing technical guidance on complex claims and litigation.
The Float Claims Specialist manages lower-level, non-complex workers’ compensation claims under the supervision of a senior claims professional. Responsibilities include confirming policy coverage, determining claim validity, establishing reserves, and communicating claim status.
The Medical Only Claims Specialist manages non-complex medical only claims and minor lost-time workers’ compensation claims under close supervision. They communicate claim status with customers, claimants, and clients while adhering to guidelines and assisting with more complex claims as needed.
The ServiceNow Developer is responsible for developing, configuring, troubleshooting, and implementing baseline and custom applications to augment the ServiceNow platform. This role also involves leading development projects, maintaining platform stability, and collaborating with stakeholders to devise innovative solutions.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and medical necessity, attending provider visits, and implementing care strategies like negotiating equipment delivery.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The Care Advocate Nurse oversees initiatives for assessing injury severity, reviewing medical data, validating information, and evaluating prescribed treatment for work-related injuries. This role functions as a nurse consultant supporting the Claims Management department by initiating contact with injured workers, employers, and providers to secure treatment plans and return-to-work status.
Senior Claims Specialist - West Virginia
CorVel Corporation
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Full Time
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4 months ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, and establishing reserves while authorizing payments within limits. This role involves developing action plans with case managers to reduce claim costs, coordinating return-to-work efforts, managing subrogation and litigation, and ensuring adherence to client and carrier guidelines.
CA WC Senior Claims Specialist (Floater)
CorVel Corporation
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Full Time
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4 months ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, establishing reserves, and authorizing payments within authority limits. This role involves developing action plans with case managers to reduce claim costs, coordinating return-to-work efforts, managing subrogation and litigation, and communicating claim status to customers and claimants.
The Account Manager serves as an executive-level customer contact, responsible for understanding expectations, communicating them to field offices, and increasing market share through excellent service and introducing additional services. Key duties include providing consultative services, managing revenue growth for accounts over $1M each, handling collections, and conducting regular client stewardship meetings.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating patient progress while ensuring treatment plans are appropriate, medically necessary, and cost-effective.
The specialist manages lower-level, non-complex workers’ compensation claims within delegated authority, ensuring the best possible outcome under senior supervision. Key duties include receiving claims, confirming coverage, determining validity, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness, often requiring significant local travel.
The Business Analyst translates workflow processes into clear business requirements and acts as a liaison between stakeholders and development teams to drive automation, quality control, and application enhancements. Key duties involve collaborating on product projects, analyzing data for insights, participating in quality assurance, and developing comprehensive documentation and training materials.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and medical necessity, attending provider visits, and developing long-term care strategies.
The Claims Training Specialist develops curricula to ensure adherence to best practices, improves quality metrics, and equips the claims workforce to meet client requirements. Responsibilities include conducting classroom, virtual, and field training, developing materials, and monitoring new hires.
The Professional Review Nurse analyzes medical services to determine the appropriateness of charges on medical bills and reviews medical reports to assess the quality of medical care provided. Key duties involve identifying review necessity, collecting and analyzing data, and using clinical expertise to detect inappropriate billing practices and errors.
