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 role. 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 Bill Review Analyst is responsible for reviewing, auditing and data-entry of medical bills for multiple states and lines of business. This is a remote 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 problems and...

The Info Security Engineer works as part of CorVel’s tight-knit, dedicated Information Security and Privacy team to contribute to the protection of corporate digital assets and reduce business risk. This role will partner with various lines of business, system- and application engineers, and business experts to research and recommend secure solutions, assess technical designs, categorize systems, select controls, provide security governance, and have a lasting and important impact to the business.     ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Foster information security practices and procedures across the organization Research, analyze, and formulate recommendations for technologies, products, and solutions to enable business Provide technical inputs, system security controls, evaluate and recommend new and emerging security products and technologies Work alongside engineering teams to evaluate security risks in technical designs and implementations...

The Director, Specialty Networks Product is a strategic leadership role within CorVel’s Network Services division. This position is responsible for overseeing the full product life cycle of the Pharmacy Benefit Management (PBM) and Ancillary Benefit Management (ABM) offerings, as well as future specialty network services products. The Director will drive the development, execution, and growth of these products, ensuring alignment with CorVel’s business objectives and delivering exceptional value to clients.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Lead and manage PBM and ABM products, with full ownership of end-to-end product life cycle, including strategy, development, launch, and ongoing optimization Develop and maintain a comprehensive product roadmap for PBM, ABM, and emerging specialty network offerings Serve as the strategic connection point across internal and external stakeholders to ensure product alignment and...

The CareIQ Intake Specialist provides administrative customer service assistance to claimants, providers, and claims management by receiving and entering new ancillary healthcare referrals. Utilizing proprietary systems and knowledge from training, a CareIQ Intake Specialist will provide excellent telephonic and written customer service to both inbound and outbound customers. A CareIQ Intake Specialist operates with a high focus on accuracy and urgency to ensure that service orders are received quickly in alignment with the claimant and customer needs. This is a remote position. The shift for this role is Monday - Friday: 12:00 PM - 8:30 PM EST. ESSENTIAL FUNCTIONS & RESPONSIBILITES: Provides quality and friendly telephonic customer service in an inbound and outbound high-volume call-center environment Completes accurate data entry and review Able to learn and operate corporate proprietary systems Enters assigned electronic (email/fax/data feed) orders...

The Workers' Compensation Product Manager is a pivotal role in ensuring the accuracy, efficiency, and effectiveness of our Enterprise Claims workers’ compensation product. This role requires a deep understanding of product knowledge, operational processes, workers’ compensation regulations, and the ability to provide business requirements to development. You will collaborate closely with cross-functional teams to enhance our product offerings, streamline workflows, and drive product development. This is a hybrid role.  ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Conduct comprehensive analyses of product, including feature performance, utilization trends, and user feedback; identify areas for improvement and recommend actionable solutions to enhance product functionality and user experience Data Analysis: Utilize techniques to extract meaningful insights and identify patterns to inform product development and optimization efforts Regulatory Compliance: Stay abreast of...

The Workers’ Compensation 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 WC 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 WC 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...

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 position. 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 Pittsburgh, PA area. Work from home, and on the road: Monday – Friday, regular business hours. Traveling outside of home for appointments in a 2-hour radius is required. 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...

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 a remote, temporary role. 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:...

The CareIQ Intake Specialist provides administrative customer service assistance to claimants, providers, and claims management by receiving and entering new ancillary healthcare referrals. Utilizing proprietary systems and knowledge from training, a CareIQ Intake Specialist will provide excellent telephonic and written customer service to both inbound and outbound customers. A CareIQ Intake Specialist operates with a high focus on accuracy and urgency to ensure that service orders are received quickly in alignment with the claimant and customer needs. This is a remote position and for continuity of business, candidate must live and work in the Central or Eastern Time Zones. The schedule for this position is Monday – Friday, 1:00 PM – 9:30 PM EST. ESSENTIAL FUNCTIONS & RESPONSIBILITES: Provides quality and friendly telephonic customer service in an inbound and outbound high-volume call-center environment Completes accurate data entry and review Able to learn...

The Permanent Northeast Floater provides experienced claims support across New York and New England, assuming temporary responsibility for diverse caseloads and clients as business needs arise.  This role manages complex and high-visibility workers’ compensation claims within delegated authority, determines benefits due, works closely with case managers and attorneys, partners with subrogation and negotiates settlements.  The position ensures customer service requirements are met while achieving optimal claim outcomes, supporting both client expectations and the goals of the CorVel claims department.  This is a remote role. Must be licensed and experienced in New York. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives assigned claims, confirms policy coverage and acknowledges the claim. Determines validity and compensability by investigating and gathering information, files necessary documentation with state agencies. Establishes reserves and authorizes...

To ensure the consistent delivery of CorVel’s total Ohio MCO workers’ compensation solution through the development, implementation and ongoing utilization of specific quality assurance tools and training leading to consistency and satisfied/loyal customers. Primary source of quality assurance and information for MCO’s Claims team. Supports management by handling quality assurance and escalated issues, monitoring representatives and completing quality assurance emails for team members. Provides informational documents such as Standard Operating Procedures, PowerPoints, emails, and departmental newsletter to assist team members in daily tasks. Assists team members in performing daily job duties. Tracks quality assurance for individuals and the department and reports quality assurance trends.   This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Conduct quality reviews/audits to ensure appropriate management of the claims and office, score the office...

The 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 hybrid role. OH jurisdiction with knowledge of WV is preferred. 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...

The 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 role is available for both remote and hybrid work arrangements. 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...

The CareIQ Client Performance Manager ensures clients have an optimized experience using CorVel’s CareIQ Ancillary Healthcare Service.  Success in this role requires a strong ability to liaise between CareIQ’s product and operations management teams and the field sales and account management teams. This includes ensuring clients are properly onboarded and trained on service utilization, and that customer expectations and setups align with operational capabilities. It also involves establishing reliable customer reporting and effectively promoting the CareIQ customer marketing message. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Completes in-person, telephonic and video training, support, and sales presentations for internal and external clients Operates as a Subject-Matter-Expert for CareIQ services, customer support, and client implementations Effectively communicates standard product and service level specifications to clients...

The Case Management Supervisor is responsible for directing the operations of their designated department, which may include one or more of the following functions: human resources, customer service, and limited sales management.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for directing a designated group of employees in their day-to-day operations Responsible for quality of service provided Responsible for human resources matters directly related to department supervised May be required to travel overnight and attend meetings May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses May be responsible for limited marketing and sales activities May be required to oversee case management clinical activities (dependent on whether or not unit manager is an RN) For Supervisors who are not RN’s, the clinical oversight and direction will be performed by a designated RN with a nationally recognized certification. This...

The Workers’ Compensation Floating 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 role. 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...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Downers Grove/ Chicago, 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. Can didate must be bilingual in both English and Spanish. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer,...

The Liability Claims Assistant will support the claims staff in the set-up and administration of General Liability claims/case management and other tasks depending on the specific customer needs.  This is a remote role. This role is part-time with the potential for full-time employment. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Sets up new claims Process incoming faxes Input notes/diary entries in the claims system Process payments, as needed Process form letters, state forms and reports Request Police Reports Additional duties as assigned KNOWLEDGE & SKILLS: Excellent written and verbal communication skills PC literate, including Microsoft Office (Word, Excel) Ability to work independently and in a team environment Strong organizational skills and adaptability Strong attention to detail EDUCATION & EXPERIENCE:  High school diploma, college degree preferred Six (6) months of service-oriented office experience...