CorVel Corporation Benefits Overview

Verifies provider, patient, and client information; requests documentation such as itemized bills, medical records, UB04s, and HCFA forms to support claims audits. Maintains production and quality standards, routes misdirected requests, protects confidential medical information, communicates issues to leadership, and may conduct outbound calls. Requires organization, analytical skills, attention to detail, independent work, and office software proficiency.

Coordinates medical care for ill or injured individuals through assessment, personalized care planning, treatment-plan evaluation, physician communication, cost containment, and resource coordination. The role provides telephonic case management, recommends medically appropriate and cost-effective care to payers, coordinates equipment and nursing services, monitors patient progress, prepares reports, and supports timely return to work. Requires an RN license, clinical experience, and case management certification or eligibility to obtain one.

Handles complex Workers’ Compensation claims, including coverage verification, claim investigation, compensability determinations, reserves, payments, return-to-work coordination, subrogation, litigation, recoveries, and settlement negotiations. Communicates with customers, claimants, attorneys, case managers, and carriers while ensuring regulatory and client compliance. Maintains claim documentation, manages action plans, supports cost containment, and contributes to claims reviews and team development.