6 bill review analyst i jobs found

The 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 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 and non-problematic medical only claims and minor 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 is seeking a dynamic and experienced Special Investigation Director to lead our Special Investigations Unit (SIU). This role is critical in safeguarding the integrity of our claims and managed care operations while ensuring compliance with regulatory standards. The ideal candidate will combine investigative expertise with strategic leadership to enhance CorVel’s market image and deliver measurable results. This is a remote role.   ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Education & Training: Develop and deliver SIU training programs for CorVel claims and managed care personnel to ensure awareness of fraud indicators and compliance requirements. Data Mining & Analysis: Utilize ISO and other data sources to identify red flags and determine when further investigation is warranted. Vendor Audits: Review and analyze audit findings from strategic vendors to ensure adherence to contractual and regulatory obligations. Regulatory & Carrier...

The Senior Claims Specialist - Strategic handles or helps support the assigned adjuster on  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.  In this role, the adjuster will be a part of the corporate claims team and made available for special projects and assignments to support the field claims organization.  Engagement with a field operation and their claims will usually last no more than 10 weeks at which time the role will be reassigned to a new strategic project. This is a Hybrid role.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the...

Company: Description: Our not-so-secret sauce. Award-winning, inclusive, Top Workplace culture doesn’t happen overnight. It’s a result of hard work by extraordinary people. More than 11,000 of the industry’s brightest talent drive our efforts to deliver purposeful work and meaningful impact every day. Learn more about what makes us different and how you can thrive as a Business Insurance Client Manager at Marsh McLennan Agency (MMA). MMA provides business insurance, employee health & benefits, retirement, and private client insurance solutions to organizations and individuals seeking limitless possibilities. With 200 offices across North America, we combine the personalized service model of a local consultant with the global resources of the world’s leading professional services firm, Marsh McLennan (NYSE: MMC). Applicants must be within driving distance to our North Atlanta (Alpharetta, GA) office to be considered for this role and have the ability to...

Company: Description: Our not-so-secret sauce. Award-winning, inclusive, Top Workplace culture doesn’t happen overnight. It’s a result of hard work by extraordinary people. More than 11,000 of the industry’s brightest talent drive our efforts to deliver purposeful work and meaningful impact every day. Learn more about what makes us different and how you can thrive as a Business Insurance Client Manager at Marsh McLennan Agency (MMA). MMA provides business insurance, employee health & benefits, retirement, and private client insurance solutions to organizations and individuals seeking limitless possibilities. With 200 offices across North America, we combine the personalized service model of a local consultant with the global resources of the world’s leading professional services firm, Marsh McLennan (NYSE: MMC). Applicants must be within driving distance to our Atlanta office to be considered for this role and have the ability to commute to the office a...

Company: Description: Our not-so-secret sauce. Award-winning, inclusive, Top Workplace culture doesn’t happen overnight. It’s a result of hard work by extraordinary people. More than 11,000 of the industry’s brightest talent drive our efforts to deliver purposeful work and meaningful impact every day. Learn more about what makes us different and how you can thrive as a Business Insurance Client Manager at Marsh McLennan Agency (MMA). MMA provides business insurance, employee health & benefits, retirement, and private client insurance solutions to organizations and individuals seeking limitless possibilities. With 200 offices across North America, we combine the personalized service model of a local consultant with the global resources of the world’s leading professional services firm, Marsh McLennan (NYSE: MMC). Applicants must be within driving distance to our Atlanta office to be considered for this role and have the ability to commute to the office a...