Provider Relations Specialist I

The Provider Relations Specialist answers phone calls from injured workers, claims examiners, attorneys, and providers. The Provider Relations Specialist assist the caller to identify their reason(a) for calling and either answers their question(s) directly via accessing the CareMC bill review system to determine status of submitted bill or transfer calls as needed to appropriate CorVel staff. This position includes a moderate to high volume of inbound and outbound calls.

This position is remote.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Create -2 or > reviews as needed for incoming faxes and or bills received from provider offices as appeals to Denver COE bill reviews.
• Receive incoming calls, emails and faxes from network.
• Provide excellent customer service and act as network liaison to injured workers, claims examiners and providers.
• Triage requests and ensure they are completed within required timeframes.
• Follow all guidelines set by the Colorado, Idaho, Utah, New Mexico, and Montana regulations
• Assist callers in navigating our website directory.
• Answer questions from callers regarding CareMC bill review or transferring the caller to the appropriate department if we unable to assist.
• Multi-task, utilize multiple programs and resources.
• Various additional duties as assigned.

KNOWLEDGE & SKILLS:

• Ability to write and speak clearly, easily communicating complex ideas across multiple platforms
• Ability to maintain composure in stressful situations and communicate diplomatically via telephone, fax, email or face to face interactions
• Ability to work independently and prioritize tasks
• Computer proficiency with the ability to utilize MS Office and other programs
• Effective quantitative, analytical and interpretive skills
• Strong interpersonal, time management and analytical skills
• Knowledge of California Workers’ Comp regulations, not required

EDUCATION & EXPERIENCE:

• Associates’ degree preferred or comparable Workers Comp experience, typically level 2+ Orange bill review skill set knowledge
• Knowledge of assigned State’s Workers’ Comp regulations
• CPC and/or expert in bill review analysis preferred
• Call center experience a plus but not required

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: $14.42 - $22.36 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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