Provider Relations Sp I

The Provider Relations Specialist assists providers via phone and email with bill review questions and requests of varying complexity. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling consistent, timely delivery of our quality services.

This role may be transitioned into a Knowledge Center Representative role within the first year of employment, based on business needs. While both the Provider Relations Specialist and the Knowledge Center Representative roles are customer support roles with overlapping core functions, specific responsibilities pertaining to only the Knowledge Center Rep role are marked as such in the below job description.

This is a remote position.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Communicate clearly and professionally with providers and other stakeholders via phone and email
• Understand Workers Compensation guidelines and various client contract language to interpret and support our bill review
• Navigate the bill review application to obtain accurate information for the callers
• Understand CorVel EORs as well as client-specific nuances
• Answer basic to complex State WC fee schedule and/or billing questions on processed medical bills covering regular as well as facility bill types
• Understand and be able to properly explain provider contracted rates, and carve-outs applied to medical bills
• Knowledge Center Rep:
  • Provide administrative customer service assistance to claimants, providers, and other interested parties by answering telephonic inquiries with a focus on first-call resolution
  • Accurately capture and enter data into CareMC and other internal systems
• Additional duties as assigned

KNOWLEDGE & SKILLS:

• Strong knowledge of fee schedule and network contracts
• Strong customer service skills and experience
• Strong organizational skills
• Ability to work independently and in a team environment
• Ability to control phone calls to ensure timely resolution and lower provider hold times
• Excellent verbal and written communication and interpersonal skills
• Working knowledge of Microsoft Office (Word, Excel)

EDUCATION & EXPERIENCE:

• Associate’s degree preferred or comparable Workers Comp experience
• Knowledge of assigned State’s Workers’ Comp regulations
• CPC and/or expert in bill review analysis preferred

PAY RANGE

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.

Pay Range: $13.38 - $23.42 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CORVEL:

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.  CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients.  We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities.  Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

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.

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