Jobs at CorVel Corporation

Lead end-to-end product management for PBM, Ancillary Benefit Management, and specialty network offerings. Define roadmap, ensure regulatory and contractual compliance, drive profitability and client metrics, coordinate cross-functional stakeholders, streamline operations, support RFP/pricing, and launch/optimize products to align with business objectives.

Coordinate telehealth inquiries via phone, email, fax; verify and enter medical referral orders; research escalations; provide coaching and training to assigned team; monitor workflows and recommend process improvements to ensure timely, accurate order submission and quality customer service.

The Claims Specialist manages lower-level workers' compensation claims, ensuring validity, compensability, and communication with clients while working under supervision.

Supervise a team of workers' compensation claims examiners, ensure compliance with WC laws and regulatory reporting, provide technical/jurisdictional guidance, coach and evaluate staff, assist with hiring/onboarding, participate in client claim reviews, and recommend claim resolutions. Must maintain WC certification and Washington claims experience.

Provide advanced, remote application support for CorVel proprietary systems: troubleshoot ServiceNow tickets, run and optimize SQL queries, perform post-release testing, create documentation, collaborate with stakeholders, and improve support using AI tools.

The Data Scientist II will design, build, and deploy machine learning models and data products, translating business problems into data-driven solutions, while collaborating with various stakeholders and ensuring reliable, production-ready outcomes.

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.

Provide remote HR support for leaves and accommodations across multiple states: maintain LOA system, manage HR inbox, assist VP HR, prepare reports and presentations, coordinate events and trainings, and handle general HR administrative duties while ensuring confidentiality and excellent employee communication.