7 medical case manager ii jobs found in Dallas, TX

The Claims Manager is responsible for the overall operation of a designated office.  The Claims Manager participates in formulating and administering company best practices as well as developing long-term goals and objectives, analyzing costs, activities and operations, supporting the goals of the Claims Department and CorVel.   This is a hybrid position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Represents the company in a professional manner to both internal and external customers and clients Directs the performance and development of the employees in their department Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Assures peak performance of the team through continued training and coaching, coupled with regular performance evaluations Utilizes jurisdictional expertise and knowledge of regulatory rules, statutes and procedures governing these jurisdictions to ensure compliance Monitors...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Austin, TX.   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 knowledge to...

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 hybrid position. 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 Customer Service Representative is responsible for addressing client and/or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as client instructions.  This role requires internet upload and download speeds of at least 80Mbps and candidate must reside in Dallas, TX area. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answer phone calls, return phone calls Answer emails from clients, providers and internal referring offices Review previous history of the provider in MedCheck, Scheck and SalesCloud Consult with Supervisor or other departments to clarify answers to inquiries Contact provider to discuss findings at the appropriate level Maintain reports and spreadsheets as needed Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Workers Compensation fee schedules and regulations Effective verbal and written...

The Customer Service Representative is responsible for addressing client and/or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as client instructions.  This role requires internet upload and download speeds of at least 80Mbps.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Answer phone calls, return phone calls Answer emails from clients, providers and internal referring offices Review previous history of the provider in MedCheck, Scheck and SalesCloud Consult with Supervisor or other departments to clarify answers to inquiries Contact provider to discuss findings at the appropriate level Maintain reports and spreadsheets as needed Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Workers Compensation fee schedules and regulations Effective verbal and written communication skills Good organizational skills and ability to multitask...

Overview The Medical Bill Review Support Analyst supports the Medical Management department's key goals of enhancing cost containment. Provides strategic and technical bill review to assist claim offices and adjusters. Accomplishes Managed Care objectives by working processes; planning and evaluating adjuster activities and Medical bill review activities.  Technical abilities and industry-specific knowledge to review Workers Compensation medical bills.   *This role is hybrid out of our Dallas, TX office* Responsibilities Plan, execute, and oversee bill audits related to state fee disputes. Assist in the development of fee dispute processes, including overall management and monitoring programs. Perform fee dispute reviews and submit relevant formwork related to re-pricing and network vendors. Review and audit bills to verify correct billing practices and contractual rates. Ongoing development of cost...

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, but candidate must live in Dallas/Fort Worth area. 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...