Medical Claims Review Manager jobs in Nampa, ID

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.

The positions is remote.

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.
• Must have and maintain Idaho Resident Claims Adjuster’s license.

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

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.

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