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CorVel Career Site

Remote Jobs

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

72 open rolesLatest: Jun 4, 2026, 7:28 AM UTC
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72 Jobs

CorVel Career Site logo

UR Intake Specialist

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Insurance9 days ago

Role Description The Utilization Review (UR) Intake Specialist provides staff support services including: - Typing reports and correspondence - File handling and forms completion - Answering incoming telephone calls - Supporting the goals of the Utilization Review / Case Management department, and of CorVel This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: - Takes calls relating to precertification requests - Verifies that all patient, provider and facility information entered in system is accurate and up to date - Enters notes and service requests in CareMC system - Communicates with stakeholders in a timely and professional manner - Additional duties as assigned Qualifications - High School diploma or equivalent required - A.A. degree or equivalent preferred Requirements - Ability to handle multiple priorities in a high-volume, fast-paced, team-oriented environment - Excellent written and verbal communication skills - Ability to meet designated deadlines - Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets - Strong interpersonal, time management and organizational skills - Ability to remain poised in stressful situations and communicate diplomatically via all methods of communication - Ability to work both independently and within a team environment Benefits - Pay Range: $16.90 - $26.92 per hour - A comprehensive benefits package is available for full-time regular employees and includes: - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off

United States
$17 - $27 / hour
CorVel Career Site logo

Appeals Representative I

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Customer Support14 days ago

Role Description The Appeals Representative is responsible for reviewing, analyzing, and addressing provider inquiries and appeals via email, fax, telephone, or written correspondence in accordance with regulatory guidelines, client policy and instructions, and industry standards, along with CMS and state guidelines. This role ensures that all appeals are set up accurately and in a timely manner, supporting the appeal process efficiently. - Receiving and analyzing appeal documentation to determine appropriate actions - Accurately setting up and initiating the appeals process timely, ensuring information aligns with provided documents - Ensure compliance with HIPAA, CMS guidelines, and client instructions and policy standards - Utilize applicable tools and resources to complete setup - Additional duties as assigned Qualifications - Knowledge of Medicare, Medicaid, and commercial insurance guidelines - Strong attention to detail, time management, and organizational skills - Excellent written and verbal communication skills - Knowledge of medical terminology and CPT/ICD codes - Proficiency with Microsoft applications Requirements - High school diploma or equivalent - 1+ years of experience in healthcare, insurance, claim processing, or customer service - 1+ years working with customers in a fast-paced, deadline-oriented environment - 1+ years of experience as an Appeals Representative - Strong technical skills with the ability to work across multiple software systems and work remotely with self-management skills Benefits - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401 K - ROTH 401 K - Paid time off Company Description CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

United States
$17 - $26 / hour
CorVel Career Site logo

Field Case Manager II

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Manager15 days ago

Role Description CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Spotsylvania, VA area. 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 discuss the current treatment plan with the physician and discuss alternate treatment plans. - Provides assessment, planning, implementation, and evaluation of patient’s progress. - Evaluates patient’s treatment plan for appropriateness, medical necessity, and cost effectiveness. - Attends doctors, other providers, home and in some cases, attorney’s visits. - Attends hospital and/or long-term facility discharge planning conferences for the purpose of determining appropriateness of care and developing an effective long-term care strategy. - Conducts home visit for initial evaluation. - Implements care such as negotiating the delivery of durable medical equipment and nursing services. - This role requires regular travel, dependent on the injured worker’s injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month. - This role may require overnight travel. - Additional duties as required. Qualifications - Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred. - Graduate of accredited school of nursing. - Current RN Licensure in state of operation. - Certification as a CCM, CIRS, or other Case Management certifications preferred. - A valid driver’s license, reliable transportation, and ability to travel to assigned locations is required. Requirements - Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment. - Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers. - A cost containment background, such as utilization review or managed care is helpful. - Strong interpersonal, time management, and organizational skills. - Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets. - Ability to work both independently and within a team environment. Benefits - A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. - Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel’s proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. Company Description CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

United States
$66.9K - $101.3K / year
CorVel Career Site logo

Senior New England Claims Specialist

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Role Description The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. Essential Functions & Responsibilities: - Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim. - Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies. - Establishes reserves and authorizes payments within reserving authority limits. - Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim. - Coordinates early return-to-work efforts with the appropriate parties. - Manages subrogation and litigation of claim as it applies. - Manages potential claim recoveries of all types. - Reports claims to the excess carrier when applicable. - Communicates claim status with the customer and claimant. - Adheres to client and carrier guidelines and participates in claims review as needed. - Develops and maintains professional customer relationships. - Complies with rules and regulations of applicable state. - Additional duties as assigned. Qualifications - Excellent written and verbal communication skills. - Ability to assist team members to develop knowledge and understanding of claims practice. - Ability to identify, analyze and solve problems. - Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets. - Strong interpersonal, time management and organizational skills. - Ability to work both independently and within a team environment. - Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation. Requirements - Bachelor's degree or a combination of education and related experience. - Minimum of 3 years’ industry experience and claim handling. - Self-Insured Certificate preferred. - State Certification or license as an experienced claims adjuster. - Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel. Pay Range CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $61,053 - $98,334 Benefits A list of our benefit offerings can be found on our CorVel website: - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Company Description CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

United States
$61.1K - $98.3K / year
CorVel Career Site logo

Repricing Quality Assurance Analyst I

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Analyst29 days ago

Role Description The Repricing Quality Assurance Analyst is responsible for reviewing, analyzing, and monitoring repricing audit data across multiple platforms to ensure accuracy, compliance, and efficiency. Works closely with internal teams to maintain contractual and organizational standards, enhance operational effectiveness, and improve client satisfaction. This is a remote position. Essential Functions & Responsibilities: - Identify and resolve quality issues within repricing processes - Develop and implement QA policies and procedures - Monitor compliance with pricing guidelines and contractual requirements - Investigate repricing discrepancies and apply corrective actions - Prepare QA reports and documentation - Collaborate with stakeholders to align quality objectives - Provide training and guidance on repricing standards - Conduct risk assessments to mitigate potential errors - Maintain confidentiality of client data, PHI, and PII - Additional duties as assigned Qualifications - Strong understanding of repricing claims processing, and contractual rate application - Knowledge of healthcare revenue cycle and reimbursement - Knowledge of applicable regulations and pricing guidelines - Proficiency in Microsoft Office and multi-platform systems - Excellent analytical, problem-solving, and communication skills - High attention to detail with the ability to work in fast-paced environments - Ability to work independently and within a team environment Requirements - 5+ years in medical/insurance repricing, claims processing, or auditing - 3+ years in quality assurance or equivalent combination of education and experience - Repricing or network contracting experience preferred - High School Diploma or higher required; Associate's or Bachelor's degree preferred Benefits - Comprehensive benefits package for full-time regular employees - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K and ROTH 401K - Paid time off Company Description CERiS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

United States
$19 - $29 / hour
Job Closed
CorVel Career Site logo

Claims Assistant

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Role Description The Claims Assistant will support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific customer needs. This is a remote position. Essential Functions & Responsibilities: - Sets up new claims - Process mail, handle files (until paperless), and input notes/diary entries in the claims system - Process payments, as needed - Process form letters, state forms and reports - Assist claims examiners with telephone calls including provider, claimant and customer calls - Additional duties as assigned Qualifications - Excellent written and verbal communication skills - PC literate, including Microsoft Office (Word, Excel) - Ability to work independently and in a team environment - Strong organizational skills Requirements - High school diploma, college degree preferred - Six (6) months of service oriented office experience preferred Benefits - Comprehensive benefits package for full-time regular employees includes: - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Company Description CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

United States
$17 - $23 / hour
Job Closed
CorVel Career Site logo

Claims Supervisor

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Role Description 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 remote role. - 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 regarding complex compensability, investigation, litigation issues and service account instructions - Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests - Participates in customer claim reviews and presentations - Ability to travel overnight and attend meetings if required - Additional duties as assigned Qualifications - Excellent written and verbal communication skills - Ability to assist team members to develop knowledge and understanding of claims practice - Effective quantitative, analytical and interpretive skills - Strong leadership, management and motivational skills - Demonstrated, strong customer service skills - Ability to maintain composure under pressure and communicate diplomatically across various channels, including telephone, email, and written correspondence - Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets - Strong interpersonal, time management and organizational skills - Ability to work both independently and within a team environment - Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation Requirements - Bachelor's degree or a combination of education and related experience - Demonstrated public speaking skills - Minimum of 5 years’ claims handling experience - Knowledge of WC required - Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel - Self-Insured Certificate preferred - State Certification as an experienced Examiner Benefits - Comprehensive benefits package for full-time regular employees - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Company Description CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

United States
$73.3K - $113.2K / year
Job Closed
CorVel Career Site logo

Telephonic Case Manager I

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Manager51 days ago

Role Description The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote role. - Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source. - Provide assessment, planning, implementation, and evaluation of patient's progress. - Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness. - Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician. - Make medical recommendations of available treatment plans to the payer. - Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services. - Devise cost-effective strategies for medical care. - Required to prepare organized reports within a specified timeframe. - Minimum Productivity Standard is 95% per month. - Additional duties as assigned. Qualifications - Ability to make independent medical decisions and recommendations to all parties. - Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment. - Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers. - Excellent written and verbal communication skills. - Ability to meet designated deadlines. - Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets. - Strong interpersonal, time management, and organizational skills. - Ability to work both independently and within a team environment. Requirements - Bachelor’s degree required, BSN preferred. - Graduate of accredited school of nursing. - Current RN Licensure in state of operation. - 3 or more years of recent clinical experience, preferably in rehabilitation. - URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire. - Strong clinical background in orthopedics, neurology, or rehabilitation preferred. - Strong cost containment background, such as utilization review or managed care helpful. - Certification as a CIRS or CCM preferred. Benefits - Comprehensive benefits package for full-time regular employees. - Medical (HDHP) w/Pharmacy. - Dental. - Vision. - Long Term Disability. - Health Savings Account. - Flexible Spending Account Options. - Life Insurance. - Accident Insurance. - Critical Illness Insurance. - Pre-paid Legal Insurance. - Parking and Transit FSA accounts. - 401K and ROTH 401K. - Paid time off. Company Description CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

United States
$63.7K - $95.3K / year
Job Closed
CorVel Career Site logo

Clinical Review Auditor I

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Auditor58 days ago

Role Description The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined by review methodologies specific to the type of review. This involves completing medical record reviews, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. This role will utilize their experience with ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. The ideal DRG Clinical Auditor candidate has strong written and verbal communication skills, clinical knowledge of disease processes, and knowledge of medical necessity rules. - The Clinical Auditor will review medical records to determine accuracy of billing through verification of coding and review of supporting clinical documentation. - Conduct audits to ensure accurate reimbursement and identifying potential savings. - Demonstrated knowledge of ICD-10-CM codes, PCS and DRG coding, understanding of payer rules and regulations, including Medicare and Medicaid. - Understand and comply with all internal and external policies. - Working knowledge of HIPAA Privacy and Security Rules. - Assist Quality Control team and medical director with appeals, rebuttals, etc. - Notify leadership of any issues or concerns in a timely manner. - Additional duties as assigned. Qualifications - Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines. - Effective and professional communication skills, both verbal and written. - Ability to work independently and in a team environment. - High attention to detail. - Must possess critical thinking skills. - Ability to multi-task and assist with team coverage and provide support when needed. - Ability to build relationships both internally and externally. - Ability to work in a fast-paced environment. - Demonstrated proficiency in basic computer skills and typing. - Proficiency with Microsoft Office. Requirements - LVN or RN license in the state of employment preferred. - CCS or CIC required with DRG auditing experience in ICD-10-CM, ICD-10 PCS. - Experience in the OR, ICU, or ER as an RN highly preferred. Pay Range CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $70,143 – $107,253 Benefits A comprehensive benefits package is available for full-time regular employees and includes: - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Company Description CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

United States
$70.1K - $107.3K / year
CorVel Career Site logo

Certified Coder II

CorVel Career Site

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Role Description The CERIS Certified Coder reverse codes previously coded medical bills to determine coding accuracy. This role is responsible for making claim-related recommendations and communicating the status of the claim to involved stakeholders. This is a remote position. Essential Functions & Responsibilities - Receives claim and processes based on state rules and regulations - Determines validity and compensability of the claim using CorVel proprietary programs - Makes recommendations and communicates claim status to referring office - Reads and comprehends all medical reports - Adheres to client and carrier guidelines and participates in claims review as needed - Assists other claims professionals with more complex or problematic claims as necessary - Maintains HIPAA compliance - Additional duties as assigned Qualifications - High School diploma or equivalent - Current AAPC certification (which must be maintained throughout employment as current and active status) - Certification as CPC with the AAPC for more than 2 years (with surgical or office experience) - Current or recent orthopedic billing/coding experience - EncoderPro software experience - E/M coding/down-coding experience - Texas workers' compensation experience is preferred - Pain Management/Anesthesia/General Surgery coding experience is preferred Requirements - Ability to learn rapidly to develop knowledge and understanding of claims practices - Strong organizational skills - Ability to meet or exceed performance competencies - Effective and professional verbal and written communication skills - Ability to handle demanding situations while using critical and strategic thinking skills - Demonstrated outstanding leadership, problem solving, and analytical skills - Ability to think and work independently, while working in an overall team environment - Proficient in Microsoft Office, especially Excel and Outlook Benefits - Comprehensive benefits package for full-time regular employees includes: - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Pay Range CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during the interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $48,143 – $71,852 Company Description CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT!). CorVel is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable.

United States
$48.1K - $71.9K / year
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