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Provider Relations Specialist I

Provider Relations Specialist I

CorVelCharlotte, NC, US
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Provider Relations Specialist I

Assists providers via phone and email with basic to complex bill review questions and requests. Documents bill review errors for tracking and trending to improve team error rate. Acts as a positive and professional representative of our CorVel family; ensures compliance with company best practice standards; ensure consistent, timely delivery of our quality services.

This is a remote role. Candidate would preferably be located in the greater Charlotte, North Carolina Region and able to attend in-office training for a minimum of 1 week at start of employment.

Essential Functions & Responsibilities :

  • Communicate clearly and professionally with callers and via email.
  • Understand Workers Compensation guidelines and various client contract language to interpret and support our bill review.
  • Maneuver in 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
  • 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 in conjunction with the Injury and Illness Prevention Program ("IIPP").
  • Additional duties as required.

Knowledge & Skills :

  • 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
  • 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
  • Pay Range : $13.08 - $22.89 per hour

    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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    Provider Specialist • Charlotte, NC, US

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