Provider Relations Specialist I

CorVel; Charlotte (NC); Remote; USD 60,000 - 80,000; Full time

Job summary

A national risk management provider is seeking a Bill Review Representative to assist providers with questions and document errors. This remote role requires clear communication, strong customer service skills, and knowledge of Workers Compensation guidelines. The ideal candidate has an associate degree or comparable experience and can work effectively both independently and in a team environment.

Benefits

Comprehensive benefits package

401K and paid time off

Career advancement opportunities

Qualifications

• Requires regular and consistent attendance.
• Knowledge of Workers Compensation guidelines.
• CPC and/or expert in bill review analysis preferred.

Responsibilities

• Assist providers with bill review questions via phone and email.
• Document bill review errors for tracking and improvement.
• Answer billing questions on various medical bills.

Skills

Excellent oral and written communication skills

PC literate, including Microsoft Office (Word, Excel)

Strong customer service skills

Strong organizational skills

Strong knowledge of fee schedule and network contracts

Excellent interpersonal skills

Ability to work in a team environment

Ability to work independently

Education

Associates’ degree preferred or comparable experience

Knowledge of assigned State’s Workers’ Comp regulations

Job description

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 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:

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: $13.08 - $22.89 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

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.