CorVel Corporation logo
CorVel Corporation

Raising the bar for care. Lowering risk for clients.

NY Medical Only Claims Specialist

Claims SpecialistClaims SpecialistFull TimeRemoteMid LevelTeam 1,001-5,000Since 1987H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

71 days ago

Salary

$17 - $27 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

NY Medical Only Claims Specialist

CorVel Corporation

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: - Receives claims, confirms policy coverage and acknowledgement of the claim - Determines the validity and compensability of the claim - Establishes reserves and authorizes payments within established reserving authority limits - 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 duties as assigned KNOWLEDGE & SKILLS: - Excellent customer service skills - Excellent written and verbal communication skills - Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology - Ability to identify, analyze and solve problems - Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets - Strong interpersonal, time management, and organizational skills - Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: - Bachelor's degree or a combination of education and related experience - Minimum of 1 year industry experience and claim handling - WC experience required - Licensed as required jurisdictionally 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: $16.74 - $26.92 per hour A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: 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!). 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. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

Related Categories

Related Job Pages

More Claims Specialist Jobs

Gallagher logo

Senior Federal Claims Adjuster - Defense Base Act

Gallagher

Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on protected characteristics by applicable federal, state, or local laws.

Full TimeRemoteTeam 5,001-10,000

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview - Jurisdictions: Federal Defense Base Act - Licenses: No license required - Location: This role is eligible for fully remote work. How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process. - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You • Claims Background: Minimum of 3-5 years of hands on workers compensation adjusting experience including handling a lost time/indemnity desk plus litigation. • Jurisdictional Experience: Federal Defense Base Act Workers Compensation and/or Longshore • Active Adjusters' licenses: No license required As a key member of our experienced Claims Adjuster team, you will: • Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution. • Work in partnership with our clients to deliver innovative solutions and enhance the claims management process • Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants REQUIRED QUALIFICATIONS: • High School Diploma. • Minimum of 5 years related claims experience. • Appropriately licensed and/or certified in all states in which claims are being handled. • Knowledge of accepted industry standards and practices. • Computer experience with related claims and business software. DESIRED: • Bachelor's Degree #LI-HS1 #LI-Remote Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

United States

• Provide prompt, courteous and high-quality customer service to all policyholders and claimants by answering customer calls and resolving customer requests • Gather necessary information from customers to initiate the claim and determine the appropriate course of action • Manage an inventory of claims, establish initial reserves for all potential exposures, and adjust as appropriate throughout the claim • Coordinate the repair, if necessary, for the property damage • Recognize requirements for potential escalation should the loss no longer meet criteria for your handling • Communicate and coordinate with involved parties regarding negotiations and settlement • Provide input for continuous development best practices, and process improvements

Arizona
Job Closed
Gallagher logo

Claims Adjuster Workers Compensation - NY, MA

Gallagher

Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on protected characteristics by applicable federal, state, or local laws.

Full TimeRemoteTeam 5,001-10,000

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview - Jurisdictions: NY, MA - Licenses: Must have state license or reciprocal. - Location: This role is fully remote work. How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims. - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution. - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements. Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file About You Ideal candidates for this position will have: • Claims Background: Minimum 3 years of experience adjusting a workers compensation desk, including lost time/indemnity and litigation. • Jurisdictional Experience: NY, MA • Active Adjusters' licenses: Must have state license or reciprocal. As a key member of our experienced Claims Adjuster team, you will: - Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution. - Work in partnership with our clients to deliver innovative solutions and enhance the claims management process. - Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants. REQUIRED QUALIFICATIONS: • High School Diploma. • Minimum of 3 years related claims experience. • Appropriately licensed and/or certified in all states in which claims are being handled. • Knowledge of accepted industry standards and practices. • Computer experience with related claims and business software. DESIRED: • Bachelor's Degree #LI-Remote #LI-AB2 Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

United States
Job Closed
Privia Health logo

Unpostables Medical Claims Biller

Privia Health

A health management technology company, Privia Health is a national practice led by physicians. The company was founded in 2007 to provide physician groups with resources dedicated

Role Description Under the direction of the Manager, Unpostables of Revenue Cycle Management, the Accounts Receivable (AR) Manager - Unpostables is responsible for overseeing the unpostables process within the RCM National Team. They identify, research and resolve unapplied cash, unidentified payments, and other discrepancies in patient accounts. The AR Manager - Unpostables ensures timely resolution of unpostable records, maintaining accurate records, and collaborating with other departments to improve processes and minimize unpostable occurrences. This role will also be responsible for taking the steps necessary to resolve all issues or questions that escalate to the unpostables team to include SalesForce case management. - Unpostables management that includes researching and resolving records that have not been matched to athenaOne related charges (including insurance payments, capitation payments, patient payments, remittance items and voided charges) - Reconciliation of re-adjudicated claims/payer takebacks - Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques as needed - Maintain payer web portal access for all payers and interfaces with athenaOne - Responsible for training internal teams (Operations, Sales) as well as care center staff when appropriate - Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality - Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs) - Other duties as assigned Qualifications - High School Graduate - 3+ years experience in a medical billing office or equivalent claims experience - Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims - Advanced Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) - Experience with athenaHeath and/or athenaOne preferred - Must comply with HIPAA rules and regulations Requirements - The hourly range for this role is $24/hr to $26.45/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). - This role is also eligible for an annual bonus targeted at 10%. - The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Benefits - Medical, dental, vision, life, and pet insurance - 401K - Paid time off - Other wellness programs Company Description Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

United States
$24 - $26 / hour
Job Closed