Current jobs related to Professional Review Specialist II - East Hartford - CorVel

  • Professional Review Specialist II

    3 months ago

    East Hartford, United States CorVel Corporation Full time

    The Professional Review Specialist provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills to determine appropriateness of medical care. This position will be in our Hartford, CT office during training, and once fully trained transition to a hybrid work arrangement.  ESSENTIAL FUNCTIONS &...

  • Professional Review Specialist II

    2 months ago

    East Hartford, United States CorVel Healthcare Corporation Full time

    Job DescriptionJob DescriptionThe Professional Review Specialist provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills to determine appropriateness of medical care. This position will be in our Hartford, CT office during training, and once fully trained transition to a hybrid work arrangement....

  • Quality Review Specialist II

    3 weeks ago

    East Millinocket, Maine, United States The Amynta Group Full time

    Job SummaryThe Quality Control Technician II is responsible for ensuring the accuracy and quality of work products across multiple departments. This role involves reviewing work products, summarizing data, and providing feedback to team members.Key ResponsibilitiesReview work products of team members to ensure accuracy and qualitySummarize data in...

  • Precision Measurement Specialist

    4 weeks ago

    Hartford, Connecticut, United States II-VI Incorporated Full time

    We are looking for a Precision Measurement Specialist for our team at II-VI Incorporated, where we manufacture advanced components for the semiconductor sector. The Precision Measurement Specialist will be responsible for assessing the flatness of both in-process and final products within a controlled cleanroom setting. Key responsibilities include the...

  • Benefits Specialist II

    4 weeks ago

    Hartford, United States Amentum Full time

    Amentum Benefits Specialist II Hartford, Connecticut Apply Now The Benefits Specialist II will support the Benefits Manager by providing administrative support in implementing company-wide health and welfare benefit programs and policies. This position is a remote-telework role. US Citizenship is required. Assist in the administration, monitoring and...

  • Optical Metrology Specialist

    2 weeks ago

    Hartford, Connecticut, United States II-VI Incorporated Full time

    Job SummaryWe are seeking a skilled Optical Metrology Specialist to join our team at II-VI Incorporated. As an Optical Metrology Specialist, you will be responsible for ensuring the quality and precision of our wafer tables, which are used in the semiconductor industry.Key ResponsibilitiesSet up, calibrate, and operate interferometers to check the flatness...

  • Template Optimization Specialist

    4 weeks ago

    Hartford, United States Hartford Healthcare Full time

    Description Job Schedule: Full Time Standard Hours: 40 Job Shift: Shift 1 Shift Details: Mon-Fri Work where every moment matters. Every day, over 30,000 Hartford HealthCare employees come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticuts most comprehensive healthcare...

  • Radiologic Imaging Specialist I, II, III

    4 weeks ago

    Hartford, Connecticut, United States DataSF Full time

    Position Overview:As a Radiologic Imaging Specialist I, II, III, you will play a vital role in delivering high-quality diagnostic imaging services. This position is designed for individuals committed to providing exceptional care while adhering to safety standards and protocols.Key Responsibilities:The essential duties of a Radiologic Imaging Specialist...

  • Tax Associate II State and Local Professional

    2 weeks ago

    Hartford, Connecticut, United States MassMutual Full time

    Unlock Your Potential as a Tax Associate II State and LocalAbout the RoleWe're seeking a highly skilled Tax Associate II State and Local to join our Corporate Tax Department. As a key member of our team, you will play a critical role in reducing our exposure to tax risks, providing high-quality tax advice, and ensuring compliance with regulatory...

  • Senior Claims Litigation Specialist II

    2 hours ago

    Hartford, Connecticut, United States CapSpecialty Full time

    Job SummaryCapSpecialty is seeking a highly skilled Senior Claims Litigation Specialist II to join our team. As a key member of our claims department, you will be responsible for investigating, evaluating, and resolving complex claims in a timely and efficient manner.Key ResponsibilitiesInvestigate and evaluate claims to determine coverage and...

  • Landscape Architecture Specialist II

    4 weeks ago

    East Lansing, Michigan, United States Michigan State University Full time

    Landscape Architecture Specialist II Job Type: Support StaffPay Grade: 12Major Administrative Unit / College: Infrastructure Planning And FacilitiesDepartment: Planning, Design, and Construction Sub Area: AP- ProfessionalsSalary: Salary CommensurateLocation: East LansingCategories: Administrative/Business/Professional, Engineers/Architects, Administrative...

  • Tax Associate II State and Local Professional

    2 weeks ago

    Hartford, Connecticut, United States MassMutual Full time

    About the RoleWe are seeking a highly skilled Tax Associate II State & Local to join our Corporate Tax Department. As a key member of our team, you will play a critical role in reducing our exposure to tax risks, providing high-quality tax advice, and ensuring compliance with regulatory requirements.Key ResponsibilitiesPrepare, review, and process annual...

  • Optical Metrology Specialist

    1 week ago

    Hartford, Connecticut, United States II-VI Incorporated Full time

    Job Title: Interferometer TechnicianWe are seeking a skilled Interferometer Technician to join our team at our Newtown, CT facility. As an Interferometer Technician, you will play a critical role in ensuring the quality of our wafer tables, which are used in the semiconductor industry.Responsibilities:Set up, calibrate, and operate interferometers to check...

  • Clinical Utilization Review Specialist

    2 weeks ago

    East Greenbush, New York, United States Albany Medical Center Full time

    Job SummaryWe are seeking a highly skilled Clinical Utilization Review Specialist to join our team at Albany Medical Center. As a key member of our Care Management department, you will play a critical role in ensuring the efficient and effective use of healthcare resources.Key ResponsibilitiesConduct thorough reviews of patient admissions and continued stays...

  • Software Engineer II

    7 days ago

    Hartford, Connecticut, United States Travelers Insurance Full time

    Job Title: Software Engineer IIWe are seeking a highly skilled Software Engineer II to join our team at Travelers Insurance. As a key member of our technology team, you will be responsible for designing, developing, and implementing software solutions that meet the needs of our customers and business stakeholders.Key Responsibilities:Design and develop...

  • Software Engineer II

    3 days ago

    Hartford, Connecticut, United States Travelers Insurance Full time

    Job Title: Software Engineer IIWe are seeking a highly skilled Software Engineer II to join our team at Travelers Insurance. As a key member of our technology team, you will be responsible for designing, developing, and implementing software solutions that meet the needs of our customers and business stakeholders.Key Responsibilities:Design and develop...

  • Risk Management Specialist II

    4 days ago

    Hartford, Connecticut, United States National Financial Partners Full time

    About the RoleWe are seeking a highly organized and self-confident Account Manager II to join our team at National Financial Partners. As a key member of our Account Management Team, you will be responsible for working closely with Advisors/Client Executives and Account Executives to service client accounts.The ideal candidate will have a strong ability to...

  • Software Engineer II

    7 days ago

    Hartford, Connecticut, United States The Travelers Companies, Inc. Full time

    Job Title: Software Engineer IIWe are seeking a highly skilled Software Engineer II to join our team at The Travelers Companies, Inc. This role will involve designing, developing, and implementing software solutions to meet the needs of our customers and business stakeholders.Key Responsibilities:Design and develop software solutions using a variety of...

  • Software Engineer II

    1 day ago

    Hartford, Connecticut, United States The Travelers Companies, Inc. Full time

    Software Engineer II Job DescriptionWe are seeking a highly skilled Software Engineer II to join our team at The Travelers Companies, Inc. This role will involve designing, developing, and implementing software solutions to meet the needs of our customers and business stakeholders.Key Responsibilities:Design and develop software applications using Java...

  • Software Engineer II

    1 day ago

    Hartford, Connecticut, United States The Travelers Indemnity Company Full time

    Job Title: Software Engineer IIWe are seeking a highly skilled Software Engineer II to join our team at The Travelers Indemnity Company. As a key member of our technology team, you will be responsible for designing, developing, and implementing software solutions that meet the needs of our customers and business stakeholders.Key Responsibilities:Design,...

Professional Review Specialist II

4 months ago

East Hartford, United States CorVel Full time

The Professional Review Specialist provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills to determine appropriateness of medical care.

This position can be hybrid once employee is fully trained.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

* Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager
* Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans
* Appropriately document work and final conclusions in designated computer program
* Requires regular and consistent attendance
* Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
* Additional duties as assigned

KNOWLEDGE & SKILLS:

* Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology
* Knowledge of applicable fee schedule and or applicable U&C Guidelines
* Proficient in Microsoft applications and technical aptitude with ability to expand knowledge and proficiency in MedCheck's proprietary systems
* Ability to work independently, follow process guidelines, meet productivity standards and timelines. (Must maintain a score of 98% or higher on performance audits)

EDUCATION & EXPERIENCE:

* Associate's degree or equivalent experience
* CPC or CPC-A required
* Previous experience in the following areas preferred:
* Medical bill auditing
* Knowledge of worker's compensation claims process
* Prospective, concurrent and retrospective utilization review



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: $21.16 - $34.04 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

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-Hybrid