17 medical case manager ii jobs found

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

Title:  Billing Specialist Location: Austin, TX/ Dallas, TX (Hybrid) Reporting To: Manager, Compliance & Customer Resolution   About Hippo: Hippo exists to protect the joy of homeownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home.   About The Role: We are seeking a detail-oriented and customer-focused Billing Specialist II to join our team. This hybrid role is responsible for processing payments and escrow transactions, resolving billing issues, and ensuring accuracy in customer financial interactions. You will be a key part of the Billing team, collaborating with multiple departments and playing a critical role in maintaining a...

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 hybrid 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...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We are seeking a detail‑oriented and analytical Investment Operations Analyst II to support the operational and analytical functions of the investment organization, with a strong emphasis on fixed income securities. The successful candidate will possess a bachelor’s degree in Finance, Economics, Accounting, or a related discipline, along with a demonstrated understanding of financial concepts, particularly bond pricing and general bond mathematics. Familiarity with data and automation tools such as SQL, Python, VBA,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Bank Third Party Governance and Programs Advisor, you will support Regulation W assessments and affiliate program activity. You will also provide support for PRCI and RCSA execution. We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Plano, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, or Tampa, FL. Relocation assistance is not available for this...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Bank Agile Product Owner Senior, you will work directly with the bank agile team to prioritize work to derive business outcomes while delivering on bank agile team commitments and ensuring the voice of the customer is strongly represented. Accountable for making decisions and prioritizing the bank agile team backlog to drive business outcomes in service to the business strategy. Act as voice of the end-user in bringing a data-driven approach to decisions and impediment removal including strategic...

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 role requires internet upload and download speeds of at least 80Mbps and candidate must reside in Dallas, TX area. 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 Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of Workers Compensation fee schedules and regulations Effective verbal and written...

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 role requires internet upload and download speeds of at least 80Mbps.   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 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...

Job Description Amazing Career Moments Happen Here      Transforming the insurance industry is ambitious, we know. That’s why at Applied, we’re building a team that shows up every day ready to learn, willing to try new things, and driven to deliver innovative software and services that make us indispensable to our customers – all within a culture built on values that make us indispensable to each other too. With 40+ years of experience in the Insurtech game, we’re not just redefining what’s achievable; we’re creating a place where amazing career moments are made possible.      Position Overview      Applied Systems, Inc., a worldwide leader in insurance technology, is currently searching for a  Sr. Associate Product Manager (Sr. AMP) to join our Product Management organization and work on the EZLynx Agency Management System. We are looking for a candidate with a proven track record for managing and implementing multiple projects...

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   The Workers Compensation Claims Specialist works within a Claims Team under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Assists in providing service to policyholders/customers on mid-sized and/or large commercial accounts.   We are open to filling this position as...

Overview The Medical Bill Review Support Analyst supports the Medical Management department's key goals of enhancing cost containment. Provides strategic and technical bill review to assist claim offices and adjusters. Accomplishes Managed Care objectives by working processes; planning and evaluating adjuster activities and Medical bill review activities.  Technical abilities and industry-specific knowledge to review Workers Compensation medical bills.   *This role is hybrid out of our Dallas, TX office* Responsibilities Plan, execute, and oversee bill audits related to state fee disputes. Assist in the development of fee dispute processes, including overall management and monitoring programs. Perform fee dispute reviews and submit relevant formwork related to re-pricing and network vendors. Review and audit bills to verify correct billing practices and contractual rates. Ongoing development of cost...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description The Negotiation Trainer develops standardized playbooks and delivers training to help adjusters navigate estimating differences, structure negotiations, and manage objections with auto body shops and contractors. This role also equips adjusters to communicate clearly, secure agreements, and deliver claim decisions in a way that builds trust and minimizes friction. Allstate is currently seeking a Negotiation Trainer based in Irving, TX to support Claims teams through in-person training and coaching. In this role, you will equip...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity This posting is for multiple P&C Actuarial Analyst positions on the pricing, indications, and forecasting teams. These roles require experienced analysts to independently apply actuarial methods for accurate pricing and process improvement, mentor colleagues, provide strategic insights, and manage business risks in compliance with internal risk management policies. We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the...

The Implementation Manager will be responsible for enhancement to existing products and development of new products to broaden current service offerings. This role will also be accountable for project management and implementation management with new and existing clients.  The primary purpose of the role is to work closely with the assigned Account Manager, Implementation Coordinators, IT, and Operations to complete the implementation of client programs and to facilitate the transition to field operations and account management personnel for ongoing servicing.   We offer a competitive salary and benefits package. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Participates in oral presentations Prepares and manages implementation plan from prospect presentation through conclusion Identifies required resources Develops and prepares information necessary for setup of customer across all CorVel systems Coordinates all internal meetings on a...

The Account Executive is responsible for interacting with customers and prospects on an executive level and acting as an extension of the client; selling new services, understanding and communicating agreed upon expectations to all teams, and increasing the market share of business by providing stellar service that meets and exceeds customer expectations, showing commitment to customer goals, and introducing/selling/implementing services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Presenting CorVel’s services to prospective customers Knowledge of CorVel's services and the disability compensation system Attend a minimum of 10 monthly sales calls Attend monthly sales strategy meeting with manager Meet or exceed sales goals established by management for the marketplace/branch office Explore all lines of coverage and needs within existing accounts and new accounts All opportunities documented in sf.com – minimum of 25 opportunities...

The Account Manager is responsible for interacting with customers on an executive level and acting as an extension of the client; understanding and communicating agreed upon expectations to field offices and increasing the market share of business by providing service that meets and exceeds customer expectations, stewardship reporting, commitment to customer goals, and introducing/selling/implementing additional services. This is a remote position, but candidate must live in Dallas/Fort Worth area. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide consultative customer services for one or more new or established accounts Introduce new services independently or with assistance as needed Handle local or regional accounts Manage accounts with revenue in one region and a minimum revenue amount of $1m per account with a combined revenue for all accounts of over $3m. Revenue growth with existing accounts Accounts Receivable - Responsible for all aspects of...

The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.  Clinical and/or technical expertise is utilized to address the provision of medical care and to identify inappropriate billing practices and errors inclusive of, but not limited to; duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with  diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and...