Jobs at CorVel Corporation

The Claims Supervisor oversees WC claims staff, ensuring compliance, performance and provides training. Responsibilities include recruitment, technical guidance, and customer interactions.

The Claims Manager oversees operations, develops best practices, ensures compliance with policies, manages staff performance, and directs claims settlement processes.

The CareIQ Billing Specialist handles invoicing for Ancillary Healthcare services, ensuring accuracy and compliance with contracted amounts. Responsibilities include customer service, data entry, and administrative reviews of bills.

The Procurement Analyst I supports Enhanced Bill Review Programs by securing medical documentation, managing inquiries, ensuring compliance with HIPAA, and meeting production goals through proactive outreach and record maintenance.

Manage complex Workers' Compensation claims from intake through resolution: investigate compensability, establish reserves, authorize payments, coordinate with case managers and attorneys, handle subrogation and litigation, negotiate settlements, report to carriers, coordinate return-to-work, maintain compliance with state regulations, and communicate claim status to customers and claimants.

Perform utilization review for inpatient and outpatient cases: collect demographic and clinical data, determine medical necessity, assign appropriate length of stay, document findings, communicate with claims staff and providers, and promote utilization review services in support of case management goals.

The Payment Integrity Analyst II performs audits and appeals on claims, requiring clinical judgment and knowledge of CMS guidelines, policy, and claims processing.

The Telephonic Case Manager coordinates care resources, develops personalized plans for treatment, and works with patients and physicians to ensure appropriate care timelines and options, focusing on quality treatment and efficiency.

Responsible for auditing medical bills for compliance with state fee schedules and guidelines, while performing data entry and maintaining accuracy.

Support Account Managers and departmental leadership by managing customer accounts, analyzing key performance indicators, and facilitating communication to resolve issues effectively.

Coordinate resources and develop personalized care plans for ill or injured individuals, supporting quality treatment and timely return to work. Communicate with healthcare providers to evaluate and recommend care options.

The Provider Management Analyst verifies provider information and documentation, ensuring accuracy in requests related to patient and provider details.

The Itemization Review Nurse analyzes billing accuracy for medical facilities, documents findings, and requires proficiency in HIPAA and data systems.

Review, analyze, and monitor repricing audit data to ensure accuracy, compliance, and efficiency. Develop QA policies, investigate discrepancies, prepare reports, train staff, and collaborate with stakeholders to maintain contractual pricing standards and protect PHI/PII.

Provides telephonic medical case management: assess, plan, implement and evaluate individualized, cost-effective care plans; communicate with physicians, patients, and payers; recommend alternative treatments; coordinate services and durable medical equipment; prepare reports and meet productivity standards.

Manage lower-level, non-complex workers' compensation indemnity claims within delegated authority: receive and validate claims, confirm coverage, establish reserves, authorize payments, communicate status with stakeholders, and assist senior claims professionals with complex cases while adhering to client and carrier guidelines.

The QA Engineer automates and executes testing for software applications, leveraging AI tools, creating complex SQL scripts, and collaborating with teams to ensure high-quality testing results in healthcare management.

The Implementation Director leads strategic and operational management of client program implementations, ensuring quality delivery and team development, while collaborating with various stakeholders.

The Claims Specialist manages low to mid Auto and General Liability claims, confirming coverage, determining validity, and communicating claim status under supervision.

The Payment Integrity Analyst II reviews and audits claims compliance with policies and CMS guidelines, utilizing clinical judgment and analytical skills.