37 medical case manager i jobs found

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Northern NJ and NYC, NY 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 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 role. 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 Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have thorough knowledge of both CPT and ICD coding Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* The Claims Examiner I obtains and analyzes data for thorough, fair, objective, and timely processing of New York State statutory Short-Term Disability and Paid Family leave claims.   The goal of the position/role is to consistently pay the accurate amount for each claim in accordance with the current laws/regulations. Research Develop an understanding and working knowledge of disability and paid family leave Develop an understanding of the applicable claim definitions and relevant provisions, clauses, exclusions, riders and waivers for the necessary requirements. Develop an operating knowledge of the applicable claims system(s). Develop basic claims skills and an understanding of claim practices and procedures. Utilizes most efficient means to obtain claim information. Analysis and Adjudication Fully investigates all relevant claim issues with oversight by Manager when...

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 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 role. 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 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 role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives 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 return-to-work efforts with the...

The Company At Utica National Insurance Group, 1,400 employees countrywide take our corporate promise to heart every day: To make people feel secure, appreciated, and respected. Utica National Insurance Group is an "A" rated $2.0B award-winning, nationally recognized property & casualty insurance carrier. Operating along the Eastern half of the United States, based in our Home Office in Central New York, with Regional Office locations including NYC, Dallas and Charlotte. Our Mission  is to continually meet the needs of our policyholders, agent/customers and employees resulting in sustainable profitable growth in an increasingly competitive marketplace. We are proud to sell our products through more than 2,200 independent insurance agents around the country as we have been since 1928. These agents provide their clients with valuable insight and resources. And, as the second-largest insurer of  Agents’ Errors and Omissions  (E&O) business in the United States,...

Position Title Branch Banking Client Consultant I - College Point NY   Location College Point, NY 11356   Job Summary The Branch Banking Client Consultant I delivers front-line client service and transactional support by welcoming clients, identifying their needs, and performing teller functions and financial transactions in an accurate, efficient, and friendly manner to support their financial goals. This role contributes to branch success by maintaining operational accuracy and risk standards, while also supporting sales performance through introductions, client education, and collaboration with branch teammates. This role exists to create a positive and trusted branch experience where clients feel supported, informed, and connected to the right financial solutions while their everyday banking needs are handled accurately and efficiently. The role also exists to support branch growth and service goals by balancing teller transaction execution, client engagement, timely...

Established in 2021,   Independence Pet Holdings   is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.   We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.  I ndependence American Insurance Company (IAIC),  a subsidiary of IPH, has over 50 years of underwriting experience and a history of innovation in the pet insurance industry. IAIC has built a reputation as a trusted and dependable partner. We are a pet-focused underwriter with deep insurance industry...

Established in 2021,   Independence Pet Holdings   is a corporate holding company that manages a diverse and broad portfolio of modern pet health brands and services, including insurance, pet education, lost recovery services, and more throughout North America.   We believe pet insurance is more than a financial product and build solutions to simplify the pet parenting journey and help improve the well-being of pets. As a leading authority in the pet category, we operate with a full stack of resources, capital, and services to support pet parents. Our multi-brand and omni-channel approach include our own insurance carrier, insurance brands and partner brands.  I ndependence American Insurance Company (IAIC),  a subsidiary of IPH, has over 50 years of underwriting experience and a history of innovation in the pet insurance industry. IAIC has built a reputation as a trusted and dependable partner. We are a pet-focused underwriter with deep insurance industry...

Position Title Branch Banking Client Consultant I - West Hempstead NY   Location West Hempstead, NY 11552   Job Summary The Branch Banking Client Consultant I delivers front-line client service and transactional support by welcoming clients, identifying their needs, and performing teller functions and financial transactions in an accurate, efficient, and friendly manner to support their financial goals. This role contributes to branch success by maintaining operational accuracy and risk standards, while also supporting sales performance through introductions, client education, and collaboration with branch teammates. This role exists to create a positive and trusted branch experience where clients feel supported, informed, and connected to the right financial solutions while their everyday banking needs are handled accurately and efficiently. The role also exists to support branch growth and service goals by balancing teller transaction execution, client engagement,...

Position Title Branch Banking Client Consultant I - Huntington Station NY   Location Huntington Station, NY 11746   Job Summary The Branch Banking Client Consultant I delivers front-line client service and transactional support by welcoming clients, identifying their needs, and performing teller functions and financial transactions in an accurate, efficient, and friendly manner to support their financial goals. This role contributes to branch success by maintaining operational accuracy and risk standards, while also supporting sales performance through introductions, client education, and collaboration with branch teammates. This role exists to create a positive and trusted branch experience where clients feel supported, informed, and connected to the right financial solutions while their everyday banking needs are handled accurately and efficiently. The role also exists to support branch growth and service goals by balancing teller transaction execution, client...

Position Title Branch Banking Client Consultant I - Valley Stream NY   Location Valley Stream, NY 11580   Job Summary The Branch Banking Client Consultant I delivers front-line client service and transactional support by welcoming clients, identifying their needs, and performing teller functions and financial transactions in an accurate, efficient, and friendly manner to support their financial goals. This role contributes to branch success by maintaining operational accuracy and risk standards, while also supporting sales performance through introductions, client education, and collaboration with branch teammates. This role exists to create a positive and trusted branch experience where clients feel supported, informed, and connected to the right financial solutions while their everyday banking needs are handled accurately and efficiently. The role also exists to support branch growth and service goals by balancing teller transaction execution, client engagement, timely...

Position Title Branch Banking Client Consultant I - Howard Beach NY   Location Howard Beach, NY 11414   Job Summary The Branch Banking Client Consultant I delivers front-line client service and transactional support by welcoming clients, identifying their needs, and performing teller functions and financial transactions in an accurate, efficient, and friendly manner to support their financial goals. This role contributes to branch success by maintaining operational accuracy and risk standards, while also supporting sales performance through introductions, client education, and collaboration with branch teammates. This role exists to create a positive and trusted branch experience where clients feel supported, informed, and connected to the right financial solutions while their everyday banking needs are handled accurately and efficiently. The role also exists to support branch growth and service goals by balancing teller transaction execution, client engagement, timely...

Position Title Branch Banking Client Consultant I   Location Valley Stream, NY 11580   Job Summary The Branch Banking Client Consultant I delivers front-line client service and transactional support by welcoming clients, identifying their needs, and performing teller functions and financial transactions in an accurate, efficient, and friendly manner to support their financial goals. This role contributes to branch success by maintaining operational accuracy and risk standards, while also supporting sales performance through introductions, client education, and collaboration with branch teammates. This role exists to create a positive and trusted branch experience where clients feel supported, informed, and connected to the right financial solutions while their everyday banking needs are handled accurately and efficiently. The role also exists to support branch growth and service goals by balancing teller transaction execution, client engagement, timely problem resolution,...

Position Title Branch Banking Client Consultant I - West Hempstead NY   Location West Hempstead, NY 11552   Job Summary The Branch Banking Client Consultant I delivers front-line client service and transactional support by welcoming clients, identifying their needs, and performing teller functions and financial transactions in an accurate, efficient, and friendly manner to support their financial goals. This role contributes to branch success by maintaining operational accuracy and risk standards, while also supporting sales performance through introductions, client education, and collaboration with branch teammates. This role exists to create a positive and trusted branch experience where clients feel supported, informed, and connected to the right financial solutions while their everyday banking needs are handled accurately and efficiently. The role also exists to support branch growth and service goals by balancing teller transaction execution, client engagement,...

Position Title Commercial Loan Operations Administrator Sr.   Location Hicksville, NY 11801   Job Summary The Senior Commercial Loan Operations Administrator plays a key clerical and administrative support role within the Commercial Loan Operations team. This position is responsible for managing loan documentation, preparing physical and digital loan files, coordinating document imaging, and supporting the overall workflow of the department. Unlike system-facing associates, this role does not require loan system entry but is critical in ensuring that the documentation and compliance components of commercial loans are well-organized and audit-ready.   Job Responsibilities: Prepare, organize, and maintain physical and electronic loan files in accordance with internal policies and regulatory guidelines. Review loan documentation for completeness and file accuracy prior to imaging or record retention. Coordinate document scanning, indexing, and quality assurance with...

Position Title Financial Consultant Location Garden City, NY 11530 Job Summary The Financial Consultant has the primary responsibility of retaining and expanding company relationships and soliciting new retail Investment and Insurance business from prospective customers. Advise and assist Flagstar customers in optimizing their financial position by creating a customized investment strategy designed around their goals, time frame, and comfort level with market risk. Job Responsibilities: JOB RESPONSIBILITIES     Meets with   customers or prospects to discuss their financial needs and outline   appropriate financial   products that meet the financial goals for customers.     Build and   maintain   excellent relationships with the retail bank branches. Direct the investment sales for an assigned group of retail bank licensed bankers through coaching, training, goal setting, marketing   plans   and daily support ....

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for investigating and confirming the facts of loss for the most complex automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. Mentors and provides direction to junior employees. We’re looking for a skilled Bodily Injury Litigation Adjuster with Homeowner Liability or Commercial General Liability experience to join our team! In this role, you’ll manage complex injury claims, including fractures, bilateral fractures, fatalities etc. We’re open to candidates located in Eastern or Central time zones who are eager...

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This role is available for remote, onsite and hybrid work arrangements. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in...