QA Specialist I

Join CorVel as a Quality Assurance Specialist where you will play a vital role in the review of medical reports for accuracy, ensuring proper grammar, correct medical terminology, and error-free content before finalizing for clients.

CorVel is a trusted leader in delivering innovative healthcare solutions. Our IME division specializes in services such as independent medical examinations and peer reviews, document management, and related offerings. Our diverse clientele includes property and casualty insurance carriers, law firms, third-party administrators, and government agencies. These organizations rely on our independent services to verify the validity of claims made by individuals under automotive, disability, liability, and workers' compensation insurance coverages.

This position is remote with a schedule of Monday through Friday, 7:30am-4:00pm or 8:00am-4:30pm CST. 

ESSENTIAL FUNCTIONS & RESPONSIBILITIES:

• Conduct comprehensive quality assurance reviews of medical reports, correspondence, addendums, and supplemental reviews.
• Ensure all recommendations and determinations are supported by clear, concise, and evidence-based rationales.
• Verify that client instructions and specifications are followed, and all client questions are thoroughly addressed.
• Confirm clinical citations and references are included when applicable, ensuring they are current and sourced from reputable medical journals or publications.
• Maintain the highest standards of content quality, formatting, and professional presentation in all reports, adhering to company guidelines.
• Ensure compliance with client specifications and state mandates by verifying that the appropriate board-certified specialist has reviewed the case and documented it accurately.
• Confirm peer reviewers attest only to the facts of the case and verify there is no evidence of conflict of interest.
• Verify provider credentials and signatures are properly included in final reports.
• Identify inconsistencies in reports and collaborate with providers to obtain necessary clarifications, modifications, or corrections.
• Assist in resolving customer complaints and quality assurance issues as needed.
• Ensure adherence to all federal ERISA and state mandates.
• Provide feedback and recommendations to management regarding consultant quality, availability, and compliance with company policies and client requirements.
• Promote efficient and effective use of company resources.
• Participate in educational and training activities as required.
• Perform additional duties as assigned.
• Must possess the ability to manage change, delays, or unexpected events appropriately.
• Demonstrates reliability and abides by the company attendance policy.

KNOWLEDGE & SKILLS:

• Knowledge of the insurance industry preferable claims management relative to one or more of the following: workers’ compensation, no-fault, liability and/or disability
• Strong understanding of medical terminology, anatomy and physiology, medications, and laboratory values.
• Typing proficiency of at least 40 W.P.M. preferred.
• Proficiency in various software applications, including Microsoft Word, Outlook, Excel, and web-based programs.
• Excellent command of English language skills, including grammar, punctuation, and style.
• Ability to accurately follow instructions and respond effectively to upper management's directions.
• Demonstrates a high level of accuracy and attention to detail.
• Exceptional communication skills, with the ability to convey information clearly, actively listen, and seek clarification when needed.
• Capable of working independently, managing priorities effectively, and using time efficiently.
• Maintains confidentiality in all aspects of work.
• Ability to remain focused and productive in environments with normal or high levels of distraction.
• Perform well under pressure and manage stressful situations with composure.
• Adaptable to changes, delays, and unexpected challenges.
• Reliable and consistently adheres to the company’s attendance policies.

EDUCATION & EXPERIENCE:

• High school diploma or equivalent required.
• Minimum of two years’ experience in a claims and/or clinical medical office or medical field setting.

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: $21.67 - $34.86 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.

#LI-Remote

Salary : $22 - $35