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Managed Care Claims Expert

2 months ago

Syracuse, New York, United States CorVel Corporation Full time
CorVel MCO Claims Specialist

The MCO Claims Specialist plays a pivotal role in supervising the performance and updates of the claims department. This position entails managing and maintaining an assigned Book of Business (BoB) that consists of lower premium employers. The specialist acts as the main point of contact for both employers and injured associates, streamlining the intake process and collaborating closely with Account Managers to ensure an exceptional customer experience.

Key Responsibilities:
  • Retention and management of the assigned Book of Business
  • Conducting intake and triage operations
  • Ensuring compliance with capacity statistics
  • Engaging in telephonic communication with the Book of Business
  • Providing weekly oversight of MoD
  • Potential travel requirements
  • Understanding of BWC Discount Programs
  • Acting in a consultant-like capacity with EOR
  • Resolving conflicts and addressing problems
  • Collaborating with Account Managers
  • Generating ad hoc reports
  • Participating in additional projects as assigned
Required Knowledge & Skills:
  • Exceptional customer service abilities
  • Strong written and verbal communication skills
  • Effective problem-solving capabilities
  • Proficiency in computer applications (MS Office)
  • Strong interpersonal and organizational skills
Education & Experience Requirements:
  • Bachelor's degree or equivalent experience
  • At least 1 year of relevant industry experience
Compensation:

$25.69 per hour

About CorVel Corporation

CorVel Corporation is a nationwide provider of risk management solutions across various sectors. We are dedicated to delivering innovative and integrated solutions to our clients. With a workforce of over 4,000 employees throughout the United States, we uphold values of Accountability, Commitment, Excellence, Integrity, and Teamwork (ACE-IT). Our comprehensive benefits package is available for full-time employees.

CorVel is an Equal Opportunity Employer and adheres to ADA regulations.