Provider Relations Specialist

2 weeks ago


Rancho Cucamonga, California, United States CorVel Corporation Full time
Job Summary

CorVel Corporation is seeking a highly skilled and detail-oriented Provider Relations Specialist to join our team. As a key member of our risk management team, you will be responsible for assisting providers with bill review questions and requests, documenting errors for tracking and trending, and ensuring compliance with company best practice standards.

Key Responsibilities
  • Communicate clearly and professionally with providers via phone and email.
  • Understand Workers Compensation guidelines and client contract language to interpret and support bill review.
  • Maneuver in the bill review application to obtain accurate information for providers.
  • Understand CorVel EORs and client-specific nuances.
  • Answer basic to complex State WC fee schedule and/or billing questions on processed medical bills.
  • Understand and explain provider contracted rates and carve-outs applied to medical bills.
  • Requires regular and consistent attendance.
  • Ability to control phone calls to ensure timely resolution and lower provider hold times.
  • Comply with all safety rules and regulations during work hours.
Requirements
  • Excellent oral and written communication skills.
  • PC literate, including Microsoft Office (Word, Excel).
  • Strong knowledge of fee schedule and network contracts.
  • Strong customer service skills and experience.
  • Strong organizational skills.
  • Excellent interpersonal skills.
  • Ability to work in a team environment.
  • Ability to work independently.
Preferred Qualifications
  • Associates' degree or comparable Workers Comp experience.
  • Knowledge of assigned State's Workers' Comp regulations.
  • CPC and/or expert in bill review analysis.
Benefits

CorVel Corporation offers a comprehensive benefits package, including medical, 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 Corporation is an Equal Opportunity Employer and complies with ADA regulations as applicable.



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