42 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...

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

Position Title AML Investigations Manager   Location New York, NY 10018   Job Summary An AML Investigations Manager assists the Bank Secrecy/OFAC Officer and the Director, Financial Intelligence Unit with maintaining certain aspects of the Bank's BSA/AML compliance program and assists in meeting and maintaining BSA/AML compliance requirements of the Bank. Complies with all applicable, federal and state laws, regulations and guidance, including those related to Anti-Money Laundering (i.e. Bank Secrecy Act, USA PATRIOT Act, etc.), as well as adhering to the Bank’s policies and procedures to reduce loss/risk to the Bank. Manages a team of BSA/AML Investigators in the Financial Investigations Unit that conduct reviews and investigations that may range from routine to the highest level of complexity and perform in depth research and detailed account analysis reviewing and investigating cases on the Bank’s Case Management System. Ensures that AML investigations are completed...

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 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...

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 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 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 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 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...

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...

Position Title Branch Banking Client Consultant II-Licensed   Location Oceanside, NY 11572   Job Summary Branch Banking Client Consultant I is responsible for interacting with clients and providing exceptional service by greeting them as they enter one of our branches and providing them with the services needed to meet their financial goals. This role will process financial transactions in an accurate, efficient, and friendly manner while maintaining operational standards, and assist the team in meeting branch goals.   Job Responsibilities: JOB RESPONSIBILITIES Sales Performance: Support team efforts to achieve growth targets in financial performance (outstanding deposits, outstanding loans, non-interest income) and primary client acquisition. Actively seek and deliver the right client introductions to the right team member(s) to achieve growth targets and execute successful sales initiative Client Experience: Provide positive client experience by assisting...

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 The Claims Inside Auto Analyst II is responsible for investigating and confirming the facts of loss for automobile accidents. This role determines coverage, liability, damages and otherwise adjusts and negotiates claims within authority. We are seeking an Auto Adjuster to join our Northeastern team. This role will primarily manage claims in New York, Maine, Massachusetts, and Connecticut. The ideal candidate will bring prior claims experience and demonstrate the ability to handle claims independently from First Notice of Loss (FNOL) through resolution. The position supports specialty lines of...

Position Title Branch Banking Client Consultant I   Location Plainview, NY 11803   Job Summary Branch Banking Client Consultant I is responsible for interacting with clients and providing exceptional service by greeting them as they enter one of our branches and providing them with the services needed to meet their financial goals. This role will process financial transactions in an accurate, efficient, and friendly manner while maintaining operational standards, and assist the team in meeting branch goals.   Job Responsibilities: JOB RESPONSIBILITIES Sales Performance: Support team efforts to achieve growth targets in financial performance (outstanding deposits, outstanding loans, non-interest income) and primary client acquisition. Actively seek and deliver the right client introductions to the right team member(s) to achieve growth targets and execute successful sales initiative Client Experience: Provide positive client experience by assisting with account...

Position Title Branch Banking Client Consultant I   Location College Point, NY 11356   Job Summary Branch Banking Client Consultant I is responsible for interacting with clients and providing exceptional service by greeting them as they enter one of our branches and providing them with the services needed to meet their financial goals. This role will process financial transactions in an accurate, efficient, and friendly manner while maintaining operational standards, and assist the team in meeting branch goals.   Job Responsibilities: JOB RESPONSIBILITIES Sales Performance: Support team efforts to achieve growth targets in financial performance (outstanding deposits, outstanding loans, non-interest income) and primary client acquisition. Actively seek and deliver the right client introductions to the right team member(s) to achieve growth targets and execute successful sales initiative Client Experience: Provide positive client experience by assisting with...

Position Title Branch Banking Client Consultant I   Location New Hyde Park, NY 11040   Job Summary Branch Banking Client Consultant I is responsible for interacting with clients and providing exceptional service by greeting them as they enter one of our branches and providing them with the services needed to meet their financial goals. This role will process financial transactions in an accurate, efficient, and friendly manner while maintaining operational standards, and assist the team in meeting branch goals.   Job Responsibilities: JOB RESPONSIBILITIES Sales Performance: Support team efforts to achieve growth targets in financial performance (outstanding deposits, outstanding loans, non-interest income) and primary client acquisition. Actively seek and deliver the right client introductions to the right team member(s) to achieve growth targets and execute successful sales initiative Client Experience: Provide positive client experience by assisting with...

Position Title Sr Auditor   Location New York, NY 10018   Job Summary The Senior Auditor is an experienced professional focused on providing assurance for the company through the development of an audit plan, supporting the overall objectives of the department working closely with the Audit in Charge (AIC). The role of the Senior Auditor requires a deep understanding of financial and regulatory frameworks identifying discrepancies or risks that could impact the financial health of the bank. This is a critical role in the Internal Audit Department. The Senior Auditor serves as the Auditor responsible for ensuring testing and workpapers are completed with high quality in support of the AIC (Auditor in Charge). Responsible for the preparation of audit documents including audit engagements, planning memorandums, preliminary opening discussion documents, audit programs and wrap up documents in assigned vertical. This position will assess policies, procedures and supporting...

Position Title Sr Auditor - Fraud Risk   Location New York, NY 10018   Job Summary The Senior Auditor is an experienced professional focused on providing assurance for the company through the development of an audit plan, supporting the overall objectives of the department working closely with the Audit in Charge (AIC). The role of the Senior Auditor requires a deep understanding of financial and regulatory frameworks identifying discrepancies or risks that could impact the financial health of the bank. This is a critical role in the Internal Audit Department. The Senior Auditor serves as the Auditor responsible for ensuring testing and workpapers are completed with high quality in support of the AIC (Auditor in Charge). Responsible for the preparation of audit documents including audit engagements, planning memorandums, preliminary opening discussion documents, audit programs and wrap up documents in assigned vertical. This position will assess policies, procedures and...

Position Title Sr Auditor   Location New York, NY 10018   Job Summary The Senior Auditor is an experienced professional focused on providing assurance for the company through the development of an audit plan, supporting the overall objectives of the department working closely with the Audit in Charge (AIC). The role of the Senior Auditor requires a deep understanding of financial and regulatory frameworks identifying discrepancies or risks that could impact the financial health of the bank. This is a critical role in the Internal Audit Department. The Senior Auditor serves as the Auditor responsible for ensuring testing and workpapers are completed with high quality in support of the AIC (Auditor in Charge). Responsible for the preparation of audit documents including audit engagements, planning memorandums, preliminary opening discussion documents, audit programs and wrap up documents in assigned vertical. This position will assess policies, procedures and supporting...

Position Title Branch Banking Client Consultant I PT   Location West Babylon, NY 11704   Job Summary Branch Banking Client Consultant I is responsible for interacting with clients and providing exceptional service by greeting them as they enter one of our branches and providing them with the services needed to meet their financial goals. This role will process financial transactions in an accurate, efficient, and friendly manner while maintaining operational standards, and assist the team in meeting branch goals.   Job Responsibilities: JOB RESPONSIBILITIES Sales Performance: Support team efforts to achieve growth targets in financial performance (outstanding deposits, outstanding loans, non-interest income) and primary client acquisition. Actively seek and deliver the right client introductions to the right team member(s) to achieve growth targets and execute successful sales initiative Client Experience: Provide positive client experience by assisting with...