Jobs at CorVel Corporation

Schedule and confirm IME appointments with physicians, clients, and patients; prepare charts and exam notifications; coordinate records, ancillary services, invoicing, and provider payments; maintain records and follow state guidelines.

Manage complex workers' compensation claims from intake through resolution: investigate compensability, set reserves, coordinate case management and return-to-work, handle subrogation and litigation, negotiate settlements, report to carriers, and maintain regulatory and client compliance while delivering strong customer service.

Review and analyze all charges on facility-submitted bills to determine billing accuracy. Collect supporting data, document findings in CERIS, apply knowledge of surgical implants and HIPAA, and collaborate with leadership to resolve discrepancies. Work independently and use Microsoft Office tools.

Manage non-complex workers' compensation indemnity claims within delegated authority: verify coverage, determine compensability, establish reserves, authorize payments, communicate with stakeholders, follow client/carrier guidelines, and support senior claims staff on complex matters.

Lead and perform pre- and post-pay claim audits using client policy, CMS guidelines, and industry standards; oversee QC analysts, conduct internal audits and appeals, develop QA measures, train staff, and research payment policy best practices.

Provide telephonic medical case management for injured or ill individuals: assess needs, develop and implement cost-effective care plans, coordinate with physicians, payers, employers and providers, recommend treatment alternatives, arrange durable medical equipment and nursing services, prepare timely reports, and meet productivity standards.

Review, audit, and data-enter medical bills for multiple states and lines of business to ensure adherence to state fee schedules, customer guidelines, PPO discounts, and coding standards. Meet accuracy and productivity targets and perform related duties as assigned.

Lead and develop a 24/7 National Help Desk delivering tier-one support; manage SLAs, incident management, staffing, training, and reporting; drive adoption of AI, automation, and modern service management technologies to improve service delivery and operational performance.

The Senior Claims Specialist manages complex Workers' Compensation claims, coordinating with case managers and attorneys and negotiating settlements to ensure optimal outcomes and compliance with regulations.

Obtain medical documentation (itemizations, records) for claims via outbound calls, email, or fax; respond to inbound provider inquiries; maintain accurate records; verify documentation quality and HIPAA compliance; meet production and quality targets; escalate issues and assist with training as needed.

The Senior Claims Specialist manages complex Workers' Compensation claims, coordinating with case managers and attorneys to ensure optimal outcomes and customer satisfaction, while adhering to guidelines and supporting strategic projects.

The No Fault Claims Specialist manages non-complex claims, confirms policy coverage, communicates with clients, and authorizes payments under supervision.

The Implementation Coordinator I manages implementation projects, oversees customer onboarding, communicates scope and status, facilitates data transfers, and fosters team collaboration to ensure timely project delivery.

The Account Manager II oversees customer relationships, manages account service delivery, drives revenue growth, and ensures client satisfaction through consultative services and regular communication with clients and internal teams.

The Case Management Supervisor RN directs departmental operations, manages employees, oversees quality service, and handles human resources matters, ensuring compliance and effective case management strategies.

Handle complex Workers' Compensation claims, ensuring coverage validity, managing subrogation and settlements, and maintaining customer relationships.

The Claims Specialist manages lower-level workers' compensation claims, ensuring policy coverage and validity while communicating with clients under supervision.

The Senior Software Engineer - AI will develop and enhance software systems using AI models, and build machine learning pipelines while ensuring best practices in software engineering are implemented.

The Claims Supervisor oversees claims staff, ensuring compliance with laws, training, and performance evaluations, and assists with strategic projects.

The Indemnity Claims Specialist manages non-complex workers' compensation claims under supervision, ensuring compliance and effective communication with stakeholders.