Jobs at CorVel Corporation

Coordinates telephonic medical case management for ill or injured individuals. Assesses treatment plans, medical necessity, and cost effectiveness; develops personalized care strategies; collaborates with physicians, patients, providers, employers, payers, and claims staff; coordinates equipment and nursing services; makes care recommendations; and prepares timely reports.

Provides phone and email support to healthcare providers regarding workers’ compensation medical bill reviews. Interprets state fee schedules, client contracts, provider rates, carve-outs, and explanation of review details. Documents billing errors, navigates bill review systems, answers billing questions, ensures compliance with company standards, and delivers timely, professional service remotely.

Handles complex workers’ compensation claims, including coverage verification, compensability investigations, reserves, payments, subrogation, litigation, settlements, recoveries, regulatory filings, and excess-carrier reporting. Coordinates with case managers, attorneys, customers, claimants, and other stakeholders to reduce claim costs and support return-to-work efforts. Maintains compliant documentation, customer relationships, and claim-handling standards while providing expertise to team members.

Supports workers’ compensation claims administration by setting up claims, processing mail, files, payments, forms, reports, and system entries. Assists claims examiners with provider, claimant, and customer calls while maintaining organized records and providing administrative support. The role requires strong communication, organization, independent work, teamwork, and proficiency with Microsoft Office.

Manages lower-level, non-complex workers’ compensation claims under supervision. Responsibilities include verifying coverage, determining claim compensability, setting reserves, authorizing payments within limits, communicating claim status, following client and carrier guidelines, and supporting senior claims professionals with complex cases.

Leads strategic business development, client relationship expansion, retention, and executive stakeholder engagement. Guides discussions on current offerings, new products, and future expansions; oversees partner alignment and brand consistency; and supports sales through subject-matter expertise, cross-selling, and growth initiatives. Requires strong negotiation, communication, client service, multitasking, and Microsoft Office skills, plus a bachelor's degree or equivalent business experience.

Reviews, audits, and enters medical bills for multiple states and business lines. Ensures bills comply with state fee schedules, customer guidelines, PPO discounts, workers’ compensation billing rules, and medical coding standards. Uses reference materials to resolve state-specific cases while meeting 98% accuracy and 10,000+ keystrokes-per-hour targets. Requires medical terminology knowledge, strong organization, communication, problem-solving, customer service, and independent work skills.

Manages non-complex liability claims under supervision, including confirming coverage, determining compensability, establishing reserves, authorizing payments within delegated limits, handling litigated files, communicating claim status, and following client and carrier guidelines. Collaborates on complex claims and maintains compliance with company procedures. The role requires strong communication, analytical, organizational, and computer skills, a bachelor’s degree or equivalent experience, and a current adjuster’s license.

Handles complex workers’ compensation claims from intake through resolution, including coverage confirmation, compensability investigations, reserves, payments, return-to-work coordination, subrogation, litigation, recoveries, and settlement negotiations. Communicates with claimants, customers, attorneys, case managers, and carriers while maintaining regulatory compliance, claim documentation, action plans, and professional relationships. Supports claims reviews and helps team members develop claims expertise.

Handles complex Workers’ Compensation claims, including coverage verification, compensability investigations, reserves, payments, subrogation, litigation, recoveries, settlement negotiations, and regulatory documentation. Coordinates return-to-work efforts with case managers and attorneys, communicates claim status to customers and claimants, reports claims to excess carriers, and maintains compliance with state regulations and client guidelines. The role also supports team knowledge development and customer relationship management.

Supervise DRG Clinical Auditors, oversee daily activities, quality, productivity, and coding accuracy. Perform DRG validation audits of inpatient medical records, verify clinically supported diagnosis and procedure codes, and document findings according to contract methodologies. Apply ICD-10, Medicare, Medicaid, CMS, payer, and regulatory guidelines. Provide team coverage, support claims denials and appeals, and maintain compliance with HIPAA and medical necessity requirements.

Develops and deploys production machine learning models and data products for enterprise use. Responsibilities include data mining, feature engineering, model evaluation, NLP and LLM/RAG solutions, API and pipeline integration, cloud-based deployment, model validation, A/B testing, documentation, and lifecycle management. The role translates business needs into scalable data science solutions and collaborates with product, engineering, and business stakeholders throughout the SDLC.

Manages lower-complexity workers’ compensation, auto, and general liability claims under supervision. Responsibilities include confirming coverage, determining compensability, establishing reserves, authorizing payments within delegated limits, communicating claim status, following client and carrier guidelines, participating in reviews, and assisting with complex claims. The role requires strong communication, organization, problem-solving, computer proficiency, and the ability to work independently and collaboratively.

Supervise workers’ compensation claims staff, ensuring quality, productivity, customer service, regulatory compliance, and adherence to company procedures. Support recruitment, onboarding, training, coaching, and performance evaluations. Provide technical and jurisdictional guidance on complex claims, investigations, litigation, and resolutions. Liaise with clients and employees, participate in claim reviews and presentations, and maintain required claims licensing or certification.

Supports claims staff by setting up and administering workers’ compensation and general liability claims. Responsibilities include processing mail and files, entering notes and diary updates, handling payments, preparing letters and state reports, and assisting with provider, claimant, and customer calls. Requires strong communication, organization, computer proficiency, and the ability to work independently and collaboratively. A high school diploma is required, while a college degree and six months of service-oriented office experience are preferred.

Handles complex California workers’ compensation claims, including coverage verification, compensability investigations, reserves, payments, action plans, return-to-work coordination, subrogation, litigation, recoveries, excess reporting, settlement negotiations, and customer communications. Maintains regulatory compliance, manages claim outcomes and costs, collaborates with case managers and attorneys, and supports claims review and team knowledge development.

Handles complex workers’ compensation claims by investigating compensability, confirming coverage, establishing reserves, authorizing payments, coordinating return-to-work efforts, managing litigation and subrogation, reporting claims, negotiating settlements, and communicating with customers and claimants. The specialist collaborates with case managers and attorneys, maintains regulatory compliance, develops cost-reduction plans, and supports claims knowledge development within the team.

Manages mid-to-complex auto and general liability claims, including bodily injury, property damage, and litigated files. Responsibilities include confirming coverage, determining compensability, investigating claims, setting reserves, authorizing payments, communicating claim status, following client and carrier guidelines, and collaborating on complex cases. The role requires significant claims experience, active adjuster licensing, strong communication and analytical skills, and proficiency with Microsoft Office and Excel.

Supports workers’ compensation claims administration by setting up claims, processing mail, files, payments, letters, state forms, and reports. Enters notes and diary entries into the claims system and assists claims examiners with calls involving providers, claimants, and customers. Requires strong communication, organization, computer literacy, and independent and collaborative work skills.

Handles complex California workers’ compensation claims, including coverage verification, compensability investigations, reserves, payments, subrogation, litigation, settlements, recoveries, regulatory filings, and return-to-work coordination. Collaborates with case managers, attorneys, customers, claimants, and carriers while maintaining documentation, reducing claim costs, meeting service expectations, and complying with applicable regulations.