The Account Manager is responsible for interacting with customers on an executive level and acting as an extension of the client; understanding and communicating agreed upon expectations to field offices and increasing the market share of business by providing service that meets and exceeds customer expectations, stewardship reporting, commitment to customer goals, and introducing/selling/implementing additional services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide consultative customer services for one or more new or established accounts Introduce new services independently or with assistance as needed Handle local or regional accounts Manage accounts with revenue in one region and a minimum revenue amount of $1m per account with a combined revenue for all accounts of over $3m. Revenue growth with existing accounts Accounts Receivable - Responsible for all aspects of collections in conjunction with the respective operations...

The Utilization Review Nurse gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP) Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have thorough knowledge of both CPT and ICD coding...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position.  ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collects supporting data and analyzes information to make decisions regarding accuracy of billing Appropriately documents work and final conclusions in designated computer program Understanding of Surgical Implants Meets department's expectations and standards  Additional duties as assigned   KNOWLEDGE & SKILLS: Understanding of Itemization Review for designated clients Understanding of CERIS systems and Data Base informatics Understanding of HIPAA regulations Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Downers Grove, IL area.   Work from home, and on the road. Monday – Friday, regular business hours.   As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families.  Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others.  This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source Utilizes their medical and nursing...

The Bill Review Analyst is responsible for reviewing, auditing and data-entry of medical bills for multiple states and lines of business. This is a Hybrid Role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts May consult reference materials in the auditing process Based upon situation or state-specific cases, meet 98% accuracy, 10,000+ keystrokes per hour Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of medical terminology, workers’ compensation billing guidelines and fee schedules Knowledge of CPT/ICD/HCPS coding Knowledge of UBO4/DWC-9/DWC-10 and CMS 1500 form types preferred Strong interpersonal skills and commitment to customer service Ability to work independently and in a team environment Ability to identify...

The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Additional duties as assigned...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Spokane, WA area. Work from home, and on the road. Monday – Friday, regular business hours.   As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families.  Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others.  This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction. Candidates must be a registered nurse in the state of Washington. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and...

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives   Workers’ Compensation  claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early...

The Qualified Rehabilitation Consultant (QRC)/Vocational Case Manager provides vocational rehabilitation services and medical case management to individuals following a work place injury through coordination with client, insurer, physician, employer, attorney and others with the ultimate goal being the client’s timely return to gainful employment. The Vocational Case Manager interviews and evaluates the client to determine the degree of disability, eligibility and feasibility of vocational rehabilitation services. This position determines suitable job goals consistent with the clients’ interests, aptitudes and physical limitations; supporting the goals of the Case Management department, and of CorVel. Candidates with case management experience or vocational rehabilitation background encouraged to apply This is a Minnesota Field Case Management position. Only MN candidates will be considered. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Schedule and carry out appointments...

The Setup Team Lead is responsible for assisting and supporting   the Setup Supervisor with ensuring   the Setup Team meets protocol. This role will assist with supervisory functions when the Setup Supervisor is absent. The Setup Team Lead is responsible for ½ production. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Must maintain ½ production quota Organize and distribute claims according to established priority Provide guidance to analysts, aiding with resolution of problems or questions Process complex/problematic claims according to protocol Maintain production standards and production requirements Comply with standard protocol for processing problem claims Function as liaison between analysts and clients Professionally communicate with other offices and internal departments Train new team members Assist co-workers, supervisor and management in accomplishing production goals Maintain HIPAA compliance in all aspects of...

The Liability Claims Specialist manages non-complex and non-problematic Heavy Auto and/or General Liability claims under direct supervision of a senior claims professional. This role aims to achieve optimal outcomes for both CorVel and our clients. The Liability Claims Specialist handles litigated files and works with delegated limited authority, adhering to company best practices. This is a remote role. Heavy Auto Liability experience is required. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Manages non-complex and non-problematic medical only claims and minor lost-time liability claims under close supervision 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 Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as...

The Senior Liability Claims Specialist manages mid to complex Heavy Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote role.  Heavy Auto and Liability experience is required. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic...

The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Additional duties as assigned...

The Administrative Assistant performs diverse administrative responsibilities for various levels of staff within the company. This position coordinates various projects and prepares reports and information which may be of a highly confidential and critical nature, supporting the goals of local management, and of CorVel. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answers phone calls Handles inquiries appropriately May open, read, prioritize, route and distribute incoming mail or other materials May coordinate, schedule, and maintain event calendars, including travel arrangements, customer appointments, meetings, conference calls, and room reservations Organizes and maintains document storage May create and prepare presentations, memos, reports, correspondence and miscellaneous projects May assist in basic accounting functions Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent...

The Workers’ Compensation Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims under close supervision, supporting the goals of the Claims Department and of CorVel.  This is a remote role; candidates must reside in New Mexico and have an active adjuster license in the state. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claims, confirms policy coverage and acknowledgement of the claim Determines the validity and compensability of the claim Establishes reserves and authorizes payments within established reserving authority limits 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 Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent customer service skills Excellent written and verbal...

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff...

The Workers’ Compensation 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 Workers’ Compensation 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 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...

The Advocacy 24/7 Triage Nurse provides telephonic first aid to injured workers on a case-by-case basis using nationally recognized standards of care to facilitate treatment goals.  The position is an essential role, requiring the ability to work a variety of shifts to cover 24/7 duties including evenings, nights, weekends and holidays. This is a remote role, candidates must reside in a nursing compact state. This role requires internet upload and download speeds of at least 80Mbps. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides telephonic assessment and makes treatment recommendation of injured workers using national telephonic triage protocols Recommends appropriate provider, based on state law and employer’s preferred provider network requirements Educates caller on self-care instructions in accordance with national telephonic triage protocols Communicates plan of care to customer contacts and/or supervisor Evaluates injured worker’s response to...

The Data Verification Analyst is responsible for all bill review clerical functions, including mail, prepping and scanning medical bills, data entry, data verification and assisting with various phone and email tasks to support the bill review department. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Validate incoming data to the Bill Review system Identify and apply customer-specific rules and processes Requires continual and consistent communication with supervisor regarding status of Data Verification queues and workload Assist the bill review department with all clerical duties as assigned Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to work on several concurrent tasks and prioritize workload with minimal direction Ability to identify, analyze and solve problems Basic computer proficiency, including familiarity with Microsoft Office applications Strong interpersonal, time management, and organizational...

The Bill Review Supervisor is responsible for the supervision of all operations within their designated department. This position functions as a member of the Bill Review Department leadership team, ensuring optimum team performance by providing exemplary support and assistance to achieve the organizational goals of excellent customer service of the bill review department and of CorVel. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Directs a team of employees in their day-to-day operations and the quality of services provided, focusing on production, timeliness, and quality of bill review performance Establishes employee performance goals and follow-up to ensure employees are achieving goals, providing encouragement, training, and coaching as needed Evaluates and maintains appropriate staffing levels to ensure work is completed within internal and external customer turn-around time expectations Responsible for maximizing department quality and...