3 manager claims operations jobs found in Rancho Cucamonga, CA

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 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 Utilization Review Case Manager 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...

The Utilization Review Case Manager 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...