• Adjust/Process claims in accordance with plan benefits • Maintain quality average of 98% • Handle adjustment requests in a timely and efficient manner • Special projects as determined by area management • Provides assistance to examiners to ensure accurate timely claims processing of adjustments • Perform other various tasks that are deemed necessary and equitable by the claims supervisors.

• Process vendor claims in accordance with plan benefits. • Maintain minimum quality and production levels as determined by the Claims Supervisor. • Maintain reconciliations as required by the vendor. • Assist the Vendor Management team with status or claim review. • Handle correspondence in a timely and efficient manner. • Resolve claim issues that do not require outside involvement. • Perform other various tasks that are deemed necessary and equitable by the Claims Supervisor

Role Description The Workers’ Compensation 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 WC 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 WC 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 - Participate 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 Workers’ Compensation required - Current license or certification in Workers’ Compensation claims must be maintained throughout employment with CorVel - State Certification or license as an experienced claims adjuster 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 Sr. AR & Case Management Specialist (Sr. AR Manager) is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The Senior AR Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. - Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role. - Overseeing functions within Accounts Receivable in accordance with compliant best practices, such as Claims Worklists, Zero Pay, Unapplied, and Denials. - Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring. - Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives. - Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques. - Serves as an escalation point, and escalates issues to the appropriate party. - Suggest and run point on policy updates as needed. - Work directly with practice consultants and/or physicians via Salesforce to ensure optimal revenue cycle functionality. - Focused on driving toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals. - Other duties as assigned. Qualifications - High School Graduate. - 5+ years experience in a physician 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. - Microsoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferred. - Experience working with athenaOne suite of tools preferred. - Experience using Salesforce for case management preferred. - Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely (if a remote worker). - Experience with VA payers & providers preferred. - Must comply with HIPAA rules and regulations. - Excellent written and verbal communication. Requirements - The hourly range for this role is $23/hr to $25/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 - All your information will be kept confidential according to EEO guidelines. - Employees who regularly work from home offices are eligible for expense reimbursement to offset internet costs. Technical Requirements - In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. - This should be acquired prior to the start of your employment. - The best measure of your internet speed is to use online speed tests like speedtest.net . - Work with your internet provider if you have questions about your connection.