Medical Only Claims Specialist

2 days ago


Birmingham, United States CorVel Corporation Full time

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 claims department and of CorVel. 

This is a remote position.

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 projects and duties as assigned

KNOWLEDGE & SKILLS:

Excellent Customer Service Skills Excellent written and verbal communication skills Ability to learn rapidly to develop knowledge and understanding of claims practice, relevant statutes and medical terminology Ability to identify, analyze and solve problems 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

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: $15.98 - $25.69 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


  • Claims Professional

    7 days ago


    Birmingham, Alabama, United States CorVel Enterprise Comp, Inc. Full time

    About the RoleAs a Claims Professional - Medical Only, you will be responsible for managing claims from initiation to closure. You will work closely with clients, claimants, and other stakeholders to ensure timely and efficient resolution of claims.Your key responsibilities will include determining claim validity, establishing reserves, and communicating...


  • Birmingham, United States CorVel Corporation Full time

    CorVel is hiring a Senior Claims Specialist for our Jackson, MS office. The Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and...


  • Birmingham, Alabama, United States CorVel Enterprise Comp, Inc. Full time

    Key ResponsibilitiesThe Senior Claims Specialist will be responsible for the following key areas:Claim Investigation: Investigate and gather information regarding claims, determine validity and compensability, and develop well-documented action plans with case managers.Reserving and Payment Authorization: Establish reserves and authorize payments within...


  • Birmingham, Alabama, United States Athens Health and Rehabilitation LLC Full time

    **About the Role:**Athens Health and Rehabilitation LLC is seeking a highly skilled Medical Claims Processor to join our team. As a critical component of our revenue cycle department, you will be responsible for accurately processing and submitting claims to ensure timely reimbursement for healthcare services.**Key Responsibilities:**Review and analyze...


  • Birmingham, Alabama, United States CorVel Enterprise Comp, Inc. Full time

    Job OverviewAt CorVel Enterprise Comp, Inc., we are seeking a highly skilled Senior Claims Specialist to join our team. This role is responsible for managing complex workers' compensation claims within company standards and best practices.The ideal candidate will have excellent communication skills, strong analytical abilities, and experience in claim...


  • Birmingham, Alabama, United States Blue Cross Blue Shield of Alabama Full time

    Required Skills and QualificationsTo succeed as a Claims Research Associate, you will need to possess excellent problem-solving and analytical skills, with the ability to work independently and as part of a team. Prior experience interacting with customers or peers, along with proficiency in Microsoft Office, is highly desirable. You should be able to adapt...


  • Birmingham, United States Spherion Full time

    Investigates, evaluates and determines compensability of claims, by performing the following duties Responsibilities: Assigned duties of Senior Claim Representative as required on daily basis. Performs investigative duties as required on case by case basis. Resolves compensable claims within applicable laws & statutes. Responsible for caseload of...


  • Birmingham, United States Spherion Full time

    Investigates, evaluates and determines compensability of claims, by performing the following duties Responsibilities: Assigned duties of Senior Claim Representative as required on daily basis. Performs investigative duties as required on case by case basis. Resolves compensable claims within applicable laws & statutes. Responsible for caseload of...


  • Birmingham, United States Gallagher Full time

    Introduction: Indulge your passion for problem-solving and embrace the thrill of addressing risk head-on at Gallagher's global brokerage team. Join a family of diverse minds, united by a relentless pursuit of excellence. As part of our team, you'll be the architect of protection, safeguarding businesses and empowering their ambitions. Together, we'll build a...


  • Birmingham, United States Athens Health and Rehabilitation LLC Full time

    Position Summary The HMO/Medicare Part A Billing Specialist is responsible for accurate and timely billing and collection of HMO and Medicare Part A claims for long term care and rehabilitation services. This role requires a strong understanding of health insurance, HMO, Medicare regulations, coding guidelines, and billing procedures. Essential Duties and...


  • Birmingham, Alabama, United States Athens Health and Rehabilitation LLC Full time

    **Job Description:**Athens Health and Rehabilitation LLC seeks a skilled Clinical Revenue Cycle Specialist to join our team. As a key member of our revenue cycle department, you will play a vital role in ensuring timely and accurate billing and collections for healthcare services.**Responsibilities:**Analyze patient medical records to ensure accurate coding...


  • Birmingham, Alabama, United States Magnet Medical Full time

    About Magnet MedicalMagnet Medical is a leading provider of healthcare services, dedicated to delivering high-quality patient care in a fast-paced environment.Salary and BenefitsThe salary package for this position includes a competitive hourly rate of $$108.72, paid bi-weekly, plus tax-free stipend amount to be determined based on 12 hour shifts and 48...


  • Birmingham, Alabama, United States Westerkamp Group, LLC Full time

    Job OverviewWe are seeking a highly skilled Biller to join our team at Westerkamp Group, LLC.Our company specializes in Revenue Cycle Management services in the healthcare industry. We review, correct, submit, and perform follow-up for third-party claims to payers for professional services reimbursement.


  • Birmingham, Alabama, United States HCAOA Full time

    Job SummaryWe are seeking a highly motivated Medical Billing and Accounting Professional to join our revenue cycle team. As a medical billing and accounting professional, you will be responsible for reviewing and editing claim forms for accuracy and completeness, as well as researching claim rejections and taking corrective actions to ensure timely claim...


  • Birmingham, United States Alabama Oncology Full time

    This position is located at the Birmingham Business Office Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent...


  • Birmingham, Alabama, United States St. Vincent Home Medical Services Full time

    About the RoleThis is an exciting opportunity for a highly motivated and organized individual to become our Medical Equipment Technician Specialist, responsible for delivering medical equipment to patients in their homes.


  • Birmingham, Alabama, United States BrightSpring Health Services Full time

    ResponsibilitiesTriage, interpret, and input orders into the computerized medication order system, meeting accuracy and productivity standards.Perform drug calculations, including basic mathematical calculations and conversions.Resolve issues related to denials and claims through adjudication and follow-up.Maintain current knowledge of Medicaid claim...


  • Birmingham, Alabama, United States OneStaff Medical Full time

    At OneStaff Medical, we're committed to providing top-notch medical care to patients in need. As a Medical Travel Nurse - Surgical Care Specialist, you'll play a vital role in delivering exceptional patient outcomes.About the RoleWe're seeking an experienced RN with a passion for Med-Surg nursing to join our team. In this 12-hour day shift position, you'll...


  • Birmingham, Alabama, United States Aureus Medical Group - Nursing Full time

    Aureus Medical Group - Nursing is a leading provider of travel nurse staffing services. We are currently seeking a skilled Nurse Specialist to join our team for a 13-week assignment in Alabama.About the AssignmentThis travel nursing opportunity is designed for experienced nurses who possess strong clinical skills and a passion for delivering exceptional...


  • Birmingham, Alabama, United States OneStaff Medical Full time

    Our MissionAt OneStaff Medical, our mission is to provide exceptional medical professionals with opportunities to excel in their careers, while upholding our values of integrity, compassion, and excellence.Compensation PackageFor this position, the weekly amount stated is based on estimated hourly wages and potential stipends available for the location of...