Jobs at CorVel Corporation

Manages non-complex liability claims under supervision, including reviewing coverage, determining compensability, establishing reserves, authorizing payments, communicating claim status, and maintaining compliance with client and carrier guidelines. Handles litigated files within delegated authority and collaborates on more complex claims. Requires liability claims experience, an active adjuster license, strong communication and organizational skills, and proficiency with Microsoft Office and Excel. This is a remote position.

Supervises liability claims staff, ensuring quality, productivity, customer service, regulatory compliance, and adherence to company procedures. Provides technical and jurisdictional guidance on complex workers’ compensation, investigation, litigation, and compensability matters. Supports recruiting, onboarding, training, coaching, evaluations, client claim reviews, and resolution of claim-related issues. Requires claims handling and supervisory experience, workers’ compensation expertise, active licensing or certification, and occasional overnight travel.

Manages non-complex liability claims under supervision, including medical-only and minor lost-time claims. Reviews coverage, determines validity and compensability, establishes reserves, authorizes payments within delegated limits, communicates with stakeholders, follows client and carrier guidelines, and collaborates on complex claims. Requires 1–3 years of auto or general liability claims experience, an adjuster’s license, and strong communication, analytical, organizational, and computer skills.

Manages mid-to-complex auto and general liability claims, including bodily injury, property damage, and litigated files. Investigates claims, confirms coverage, determines compensability, establishes reserves, authorizes payments within authority limits, and communicates claim status to customers, claimants, and clients. Collaborates on complex cases while following carrier, client, and company guidelines.

Manages non-complex medical-only and minor lost-time liability claims under supervision. Responsibilities include verifying coverage, determining claim validity and compensability, establishing reserves, authorizing payments, communicating with stakeholders, following client and carrier guidelines, and collaborating on complex claims. Requires 1–3 years of auto or general liability claims experience, a current adjuster’s license, and strong analytical, organizational, communication, and computer skills.

Manages lower-complexity workers’ compensation claims under senior supervision. Responsibilities include verifying coverage, determining claim compensability, setting reserves, authorizing payments within limits, communicating with claimants and clients, following carrier guidelines, and supporting claims reviews. The role requires strong communication, organization, problem-solving, Microsoft Office proficiency, and a current workers’ compensation license or certification.

Provides telephonic medical case management by assessing treatment plans, coordinating care and resources, recommending cost-effective alternatives, and communicating with patients, providers, employers, payers, and claims stakeholders. Develops personalized care plans, coordinates equipment and nursing services, evaluates medical necessity and progress, prepares reports, and supports timely return to work. Requires an RN license, nursing degree, clinical experience, and case management certification or eligibility to obtain one.

Manages mid-to-complex auto and general liability claims, including bodily injury, property damage, and litigated files. Responsibilities include confirming coverage, determining compensability, investigating claims, setting reserves, authorizing payments, communicating claim status, following client and carrier guidelines, and collaborating on complex cases. The role requires significant claims experience, active adjuster licensing, strong communication and analytical skills, and proficiency with Microsoft Office and Excel.

Supports workers’ compensation claims administration by setting up claims, processing mail, files, payments, letters, state forms, and reports. Enters notes and diary entries into the claims system and assists claims examiners with calls involving providers, claimants, and customers. Requires strong communication, organization, computer literacy, and independent and collaborative work skills.

Sell CorVel services to prospects and existing accounts, meet activity and sales targets, document opportunities and activity in Salesforce, respond to RFPs, attend meetings and conferences, and provide exceptional customer service to grow market share.

Provides inbound and outbound customer service while scheduling ancillary healthcare appointments for claimants. Reviews and enters data, operates proprietary systems, updates case stakeholders, prepares correspondence, and resolves scheduling challenges. Maintains accuracy, urgency, production, and quality standards in a high-volume remote call-center environment.

Identifies subrogation opportunities for workers’ compensation and property/auto claims, negotiates settlements with insurers and attorneys, sends lien notices, tracks claim status, communicates with stakeholders, researches subrogation laws, and manages a 250–300 claim queue. The role also supports inter-company arbitration and maintains client relationships while following client guidelines and participating in claim reviews.

Develops and deploys production machine learning models and data products for enterprise use. Responsibilities include data mining, feature engineering, model evaluation, NLP and LLM/RAG solutions, API and pipeline integration, cloud-based deployment, model validation, A/B testing, documentation, and lifecycle management. The role translates business needs into scalable data science solutions and collaborates with product, engineering, and business stakeholders throughout the SDLC.

Prepare, review, and submit Workers' Compensation EDI FROI and SROI filings using vendor platforms. Analyze claim data, interpret state-specific EDI implementation guides and reporting rules, resolve transaction errors/rejects, monitor compliance with deadlines, communicate with internal stakeholders, and ensure HIPAA and regulatory compliance.

Review, audit, and data-enter medical bills for multiple states and lines of business to ensure adherence to state fee schedules, customer guidelines, PPO discounts, and coding standards. Meet accuracy and productivity targets and perform related duties as assigned.

Supervise hospital bill audit nurses, ensuring accurate audits and compliance with regulations. Foster team collaboration and handle auditor inquiries while maintaining productivity standards.

Perform DRG validation reviews of medical records, document findings, provide support for coding determinations, and conduct audits to ensure accurate billing.

The Appeals Representative analyzes appeals in accordance with policies and guidelines, communicates with providers, and ensures timely completion of appeals while adhering to industry standards.