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CorVel Corporation

Provider Relations Specialist I

CorVel Corporation, Folsom, California, United States, 95630

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Location: CA - Sacramento Folsom 1180 Iron Point Rd Suite 300 Folsom, CA 95630, USA

This is a remote position.

The Provider Relations Specialist assists providers via phone and email with bill review questions and requests of varying complexity. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling a consistent, timely delivery of our quality services.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES

Communicate clearly and professionally with providers and other stakeholders via phone and email

Understand Workers Compensation guidelines and various client contract language to interpret and support our bill review

Navigate the bill review application to obtain accurate information for the callers

Understand CorVel EORs as well as client-specific nuances

Answer basic to complex State WC fee schedule and/or billing questions on processed medical bills covering regular as well as facility bill types

Understand and be able to properly explain provider contracted rates, and carve-outs applied to medical bills

Additional duties as assigned

KNOWLEDGE & SKILLS

Excellent oral and written communication skills

Working knowledge of 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 independently and in a team environment

Ability to control phone calls to ensure timely resolution and lower provider hold times

EDUCATION & EXPERIENCE

Associate’s degree preferred or comparable Workers Comp experience

Knowledge of assigned State’s Workers’ Comp regulations

CPC and/or expert in bill review analysis preferred

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.

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.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.

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