3 medical case manager ii jobs found in Norristown

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 Large Loss Workers’ Compensation Adjuster is responsible for managing a caseload of complex and high-exposure workers’ compensation claims from initial assignment to resolution. This role requires strong technical expertise in claims handling, thorough knowledge of workers’ compensation laws and regulations, and the ability to develop strategies that achieve cost-effective and fair claim outcomes. The adjuster will work closely with injured employees, employers, medical providers, attorneys, and internal stakeholders to ensure timely and accurate claim resolution. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Claim Management Handle a caseload of large loss and catastrophic workers’ compensation claims, including complex medical and indemnity exposures Investigate claims thoroughly to determine compensability, cause, extent of injuries, and potential for subrogation or fraud.  Establish and maintain accurate reserves based on file...

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 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 Requires punctual and consistent attendance 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 Detail...