CERIS

CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

Appeals Team Lead

Claims SpecialistClaims SpecialistFull TimeRemoteTeam 501-1,000

Location

United States

Posted

61 days ago

Salary

$19 - $30 / hour

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The Appeals Team Lead assists injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls. 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. This is a remote position.

Qualifications

  • 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
  • Ability to work independently and in a team environment
  • Effective quantitative, analytical and interpretive skills
  • Strong interpersonal, time management and analytical skills
  • Ability to control phone calls to ensure timely resolution and lower provider hold times

Requirements

  • Associates’ degree preferred or comparable Workers Comp experience
  • 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

Benefits

  • 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
  • Paid time off

Company Description

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!).

Job Requirements

  • 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
  • Ability to work independently and in a team environment
  • Effective quantitative, analytical and interpretive skills
  • Strong interpersonal, time management and analytical skills
  • Ability to control phone calls to ensure timely resolution and lower provider hold times
  • Associates’ degree preferred or comparable Workers Comp experience
  • 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

Benefits

  • 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
  • Paid time off

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