CorVel Corporation

Role Description The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. - Communicate with respective leadership on any issues or problems identified - Maintain production standards, production requirements, and quality of work - Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner - Timely forward misdirected requests to the correct recipient - Ensure strict confidentiality of all medical records, PHI, and PII - Outbound calling may be needed - Additional duties as assigned Qualifications - Ability to work independently - Strong organization skills - Strong analytical and problem-solving skills - Excellent attention to detail - Ability to deliver results in a timely manner - MS Office including Word, Excel, and Outlook; Windows operating system - Outbound call experience Requirements - High School Diploma or equivalent required - Demonstrated knowledge of office experience 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 - 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!).

Role Description The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. This is a remote position. Essential Functions & Responsibilities - Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication. - Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits. - Utilize applicable tools and resources to complete internal audits and/or appeals. - Timely completion of internal audits and/or appeals. - Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings. - Additional duties as assigned. Qualifications - Ability to use clinical judgment and analytical skills for claim audit review. - Knowledge of CMS/commercial payer policies, claims processing and reimbursements, IDC-10 Coding, and DRG Validation. - Familiarity with healthcare revenue cycle and coordination of benefits. - Proficiency in Microsoft Office, especially using pivot tables in Excel as well as database tools. - Excellent written and verbal communication skills. - Strong interpersonal skills across all levels; comfortable interfacing with clients and the C-Suite. - Ability to work on several concurrent tasks and prioritize workload to meet designated deadlines. - Advanced problem-solving and data analysis capabilities. - Proven track record of delivering actionable results. - Strong attention to detail. Requirements - Must maintain a current LPN, LVN and/or RN licensure. - Previous experience in one or more of the following areas required: - Medical bill auditing. - Experience in the acute clinical areas of facilities in O.R., I.C.U., C.C.U., E.R., Telemetry, Medical/Surgical, OB or L&D, Geriatrics and Orthopedics. - Knowledge of worker's compensation claims process. - Prospective, concurrent and retrospective utilization review. - 1+ years healthcare revenue cycle. - 1+ years of relevant experience or equivalent combination of education and work experience. - 1+ years hospital bill audit. - Bachelor’s degree in healthcare or related field preferred. - Preferred experience with health insurance denials and/or appeals, payer audits, or vendor audits. Benefits - CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. - Pay Range: $66,941 – $101,258. - 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.

Role Description The Case Management Coordinator provides staff support services to facilitate high quality individualized treatment goals, including timely return-to-work, if appropriate, while supporting the goals of the Case Management department, and of CorVel. This is a remote position. Essential Functions & Responsibilities: - Assists medical case managers with case management duties - Provides customer support services - Types and proofreads reports and correspondence - Transcribes correspondence/reports from dictation - Organizes client files - Additional duties as assigned Qualifications - Effective multi-tasking skills 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 work both independently and within a team environment Requirements - High School diploma or equivalent - Clinical background 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 - 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!).

Role Description The Hospital Bill Audit Manager is responsible for planning, leading, and coordinating multiple teams of nurse auditors and associated billing staff in a fast-paced, productivity-based environment. This role oversees auditors performing varying types of medical bill audits including, but not limited to, medical record audits, hospice, implant, and outpatient or ancillary facility claims. This team also performs onsite and remote hospital bill audits. Must be willing to travel for onsite facility audits and other meetings as needed. - Utilize nursing education, experience, and industry best practices to lead a team of registered nurses to plan, execute and deliver timely and accurate results. - Assist the Hospital Bill Supervisor in the training, professional development, and retention for the nurse auditors. - Ensure accuracy of audits through acquired knowledge of client policies, provider contract information, and other standard guidelines. - Assist in the development and support of auditors to meet and exceed productivity requirements based on CERIS productivity standards. - Acts as a point of contact for providers regarding onsite and remote audits. - Responsible for managing the team's daily file flow and prioritization of rush files, special projects, client special requests, test files, and other special requests as needed. - Oversee the scheduling and completion of remote and onsite audits to ensure they are worked on in an efficient and timely manner. - Responsible for identifying and understanding gaps in workflows to develop potential process improvement plans. - Research and respond to staff questions and concerns in a timely, professional manner. - Responsible for human resource matters directly related to direct and indirect staff including, but not limited to, yearly evaluations, interviewing, hiring, documentation of events or occurrences, coaching, time and attendance, and any additional personnel issues or interventions. - Responsible for daily, monthly, ad hoc reports and summaries as requested by director of audit or other executive leadership. - Participate in provider and client calls. - May be required to travel overnight and attend meetings or training for Hospital Bill Audit review. - Must be willing to travel to provider facilities for onsite audits as needed. - Additional duties as assigned. Qualifications - Knowledge of acute hospital billing requirements including UB-04, itemized bills, revenue codes, CPT/HCPCS codes, ICD10 diagnosis and procedure codes. - Knowledge of industry standards for medical bill audit based on national and state policy guidelines, including how to research those policies and guidelines and form educated decisions. - Excellent written and verbal communication skills with the ability to communicate complex ideas across multiple platforms. - Ability to interpret and answer complex questions and requests. - Ability to think critically and work independently to meet deadlines and complete priorities. - Ability to remain composed in stressful situations and communicate professionally. - Must be a team player to manage staff and create a positive team working environment. - Must be proficient with Microsoft Office applications, including Excel. - Must have exceptional organizational skills. Requirements - Associate degree and current RN license in the state of employment. Bachelor’s or Master’s degree in nursing preferred. - 3+ years of experience in healthcare facility charge and billing audit or related experience. - Previous supervisory/management experience required. - Additional certifications in nursing, business management and/or medical bill review a plus. Benefits - CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. - Pay Range: $87,190 – $134,613. - 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.

Role Description The Customer Service Representative is responsible for addressing client and/or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as client instructions. This is a remote position. This role requires internet upload and download speeds of at least 80Mbps. Essential Functions & Responsibilities: - Answer phone calls, return phone calls - Answer emails from clients, providers and internal referring offices - Review previous history of the provider in MedCheck, Scheck and SalesCloud - Consult with Supervisor or other departments to clarify answers to inquiries - Contact provider to discuss findings at the appropriate level - Maintain reports and spreadsheets as needed - Additional duties as assigned Qualifications - Knowledge of Workers Compensation fee schedules and regulations - Effective verbal and written communication skills - Good organizational skills and ability to multitask - Detail oriented - Proficiency with Microsoft applications - Medical terminology and coding knowledge Requirements - High school diploma or equivalent - Customer service experience working in the Managed Care and Benefit Administration industries 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 - 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!).

• Receives Workers’ Compensation claims, confirms policy coverage and acknowledgment of the claim • Determines validity and compensability of the claim • Establishes reserves and authorizes payments within reserving authority limits • Manages non-complex lost-time workers’ compensation claims under close supervision • Communicates claim status with the customer, claimant and client • 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 • Additional projects and duties as assigned

Role Description The Vice President of Claims will execute on the strategic goals and vision of the company. This includes the management and development of staff and revenue. This role requires a high level of analytical, interpersonal, and organizational skills and will be responsible for claims quality, customer satisfaction, and retention. The VP of Claims will also identify, facilitate, and participate in essential strategic projects for operational improvement as well as support and directly participate in sales presentations/RFP responses and the development of opportunities to promote the company’s overall growth. This is a remote position. Essential Functions & Responsibilities - Position shares responsibility for meeting and exceeding market profit and revenue goals annually. - Position shares responsibility to grow market share through accountability for customer satisfaction and retention. - Participates in marketing and sales presentations of prospective clients and cross-selling efforts of existing customers. - Executes corporate objectives by implementing policies, procedures, and practices in compliance with CorVel’s Corporate and Quality Standards. - Partners with other Claims Leaders to determine the most effective methods for addressing opportunities; collaborates with other stakeholders to ensure ongoing improvement. - Partners with Area Vice President to develop/maintain financial analysis practices for operational budgeting and staffing. - Supports national claims leadership in all aspects of strategy development, alignment, and implementation. - Collaborates with support functions (IT, HR, Legal, Finance) to develop comprehensive solutions, tools, and processes for the claims operation. - Sets and manages office benchmarks in key performance areas. - Provides consistent technical claims training to the claims team. - Ensures compliance with CorVel best practices to promote excellent customer service and instill a culture and mindset that drives continuous improvement. - Responsible for office(s) carrier compliance, department of insurance compliance, licensing, and responses to client performance concerns. - Reviews and approves claims payments in line with assigned claims approval authority levels. - Has direct reporting of Claims Supervisors and Claim Managers based on the organizational structure of the operation. - Ultimate responsibility for business unit’s quality performance: must lead office(s)/employees to achieve performance goals. - Conducts regular staff meetings; sets goals, provides operational review and learning opportunities. - Supervises, monitors, and controls the activities of the claims teams to attain specific objectives by developing and updating operating procedures, allocating resources, and/or work assignments. - Conducts or arranges training for claims teams, as needed. - Conducts regular 1:1 meetings with direct reports to review operational health. - Advises, mentors, and counsels management team, as needed. - Some overnight travel to attend meetings. - Additional duties as assigned. Knowledge & Skills - Excellent written and verbal communication skills necessary for customer contact, negotiation, presentations, project management, and personnel management. - Effective quantitative, analytical, and interpretive skills. - Excellent leadership skills, with a demonstrated ability to motivate staff and obtain results through teamwork. - Ability to function effectively under time constraints, consistently meet deadlines, and handle multiple tasks in a demanding work environment. - Ability to identify priorities, execute, and multitask in a dynamic, fast-paced environment. - Ability to travel overnight and attend meetings. - Ability to remain poised in stressful situations and communicate diplomatically via various communication channels. - Strong proficiency in Microsoft Office Suite is required. - Strong interpersonal, time management, project management, and organizational skills. - Ability to maintain a high level of professionalism. - Knowledge of the entire claims administration procedures. Education & Experience - Bachelor’s Degree with course concentration in Business Administration, or related field; or 10+ years of equivalent combination of education and experience in a complex healthcare, insurance, or third-party claim organization with significant project management expertise. - Must have significant industry experience and a deep understanding of CorVel’s proprietary systems and solutions. 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: $99,250 – $166,777 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 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 enables 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 Data Verification Specialist is responsible for all bill review clerical functions, including mail, prepping and scanning medical bills, data entry, data verification and assisting with various phone and email tasks to support the bill review department. This is a remote role. Essential Functions & Responsibilities: - Validate incoming data to the Bill Review system - Identify and apply customer-specific rules and processes - Requires continual and consistent communication with supervisor regarding status of Data Verification queues and workload - Assist the bill review department with all clerical duties as assigned - Additional duties as assigned Qualifications - Ability to work on several concurrent tasks and prioritize workload with minimal direction - Ability to identify, analyze and solve problems - Basic computer proficiency, including familiarity with Microsoft Office applications - Strong interpersonal, time management, and organizational skills - Ability to work both independently and within a team environment Requirements - High school diploma or equivalent - Experience in a professional office environment 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 - 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!).

Role Description The Junior Staff Accountant maintains the General Ledger accounts and business transactions, applying the Generally Accepted Accounting Principles (GAAP) that include analytical work and thorough review of financial records. This is a remote role. Essential Functions & Responsibilities: - Complete monthly journal entries in General Ledger including but not limited to standard, non-standard, prepaid; those with income statement impact and balance sheet items; or others as assigned. - Complete monthly Balance Sheet Fixed Assets accounts reconciliations for multiple accounts. - Process Write-offs and Refunds for AR. - Set up new vendors for PeopleSoft AP. - Work on projects as assigned by the Director of Accounting or Accounting Manager. - Special projects and ad-hoc reports. - Assist with budgets, fixed assets, taxes, audit preparation and system testing. - Safeguard operations by keeping sensitive information confidential. - Additional duties as assigned. Qualifications - Strong knowledge and understanding of accounting procedures. - Computer proficiency and technical aptitude with the ability to utilize applicable Microsoft applications to meet work needs. - Effective written and verbal communication skills. - Strong interpersonal and problem-solving skills. - Strong organizational skills and ability to prioritize workload in order to meet tight deadlines in a fast-paced and dynamic work environment. - Demonstrate a proficient level of professional skill and/or knowledge in accounting and keep current with developments and trends. - 10-key by touch. Requirements - Bachelor’s degree in finance/accounting or business. - 2 years of accounting experience in a professional business environment. 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!).

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 - 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. Requirements - 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. 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. - 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!).