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Job Description The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager, • Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans, • Appropriately document work and final conclusions in designated computer program, • Additional duties as assigned KNOWLEDGE & SKILLS: • Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology, • Knowledge of applicable fee schedule and or applicable U&C Guidelines, • Proficient in Microsoft Office applications, • Technical aptitude with the ability to expand knowledge of MedCheck’s proprietary systems, • Ability to work independently, follow process guidelines, and meet productivity standards and timelines (must maintain a score of 98% or higher on performance audits) EDUCATION & EXPERIENCE: • Associate’s degree or equivalent experience, • CPC or CPC-A required, • Previous experience in the following areas preferred:, • Medical bill auditing, • Knowledge of workers' compensation claims process, • Prospective, concurrent and retrospective utilization review 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: $18.80 - $30.34 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. #LI-Remote

Job Description The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and/or direct reporting manager, • Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans, • Utilize clinical and/or technical expertise to address the provision of medical care and identify inappropriate billing practices and errors, such as: duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc., • Document work and final conclusions in designated computer program, • Additional duties as assigned KNOWLEDGE & SKILLS: • Concise and effective verbal and written communication skills, • Ability to interface with claims adjusters, attorneys, physicians and their representatives, advisors/clients, and co-workers, • Ability to effectively promote all Professional Review products with attorneys, claims examiners, customers and management, • Strong ability to effectively negotiate provider fees, • Must be proficient with Microsoft Office applications, • Knowledge of worker's compensation claims preferred EDUCATION & EXPERIENCE: • Must maintain current licensure as a Registered Nurse in the state of employment with a minimum of 4 years clinical experience, • A minimum of an Associate Degree in Nursing as well as have a thorough knowledge of both C.P.T. and I.C.D.9 codes preferred, • Medical bill auditing experience preferred, • Experience in the clinical areas of O.R., I.C.U., C.C.U., E.R., and orthopedics preferred, • Prospective, concurrent and retrospective utilization review experience 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: $51,807 - $83,551 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

Job Description The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Receives claim, confirms policy coverage and acknowledgement of the claim, • Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies, • Establishes reserves and authorizes payments within reserving authority limits, • Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim, • Coordinates early return-to-work efforts with the appropriate parties, • Manages subrogation and litigation of claim as it applies, • Manages potential claim recoveries of all types, • Reports claims to the excess carrier when applicable, • Communicates claim status with the customer and claimant, • Adheres to client and carrier guidelines and participates in claims review as needed, • Develops and maintains professional customer relationships, • Complies with rules and regulations of applicable state, • Additional duties as assigned KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills, • Ability to assist team members to develop knowledge and understanding of claims practice, • Ability to identify, analyze and solve problems, • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets, • Strong interpersonal, time management and organizational skills, • Ability to work both independently and within a team environment, • Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation EDUCATION & EXPERIENCE: • Bachelor's degree or a combination of education and related experience, • Minimum of 6 years’ industry experience and claim handling, • Self-Insured Certificate preferred, • State Certification as an experienced Examiner 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: $59,681 - $96,123 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

Job Description The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Receives claims, confirms policy coverage and acknowledgment of the claim, • Determines validity and compensability of the claim, • Establishes reserves and authorizes payments within reserving authority limits, • Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision, • Communicates claim status with the customer, claimant and client, • Adheres to client and carrier guidelines and participates in claims review as needed, • Assists other claims professionals with more complex or problematic claims as necessary, • Additional duties as assigned KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills, • Ability to learn rapidly to develop knowledge and understanding of claims practice, • Ability to identify, analyze and solve problems, • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets, • Strong interpersonal, time management and organizational skills, • Ability to meet or exceed performance competencies, • Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: • Bachelor's degree or a combination of education and related experience, • Minimum of 1 year of industry experience and claims management preferred, • State Certification as an Experienced Examiner 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: $51,807 - $83,551 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

Job Description The New England Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Supervises claims staff in their day-to-day operations, • Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions, • Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements, • Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval), • Provides technical and jurisdictional guidance to claims staff regarding complex compensability, investigation, litigation issues and service account instructions, • Acts as a liaison by recommending and executing final resolutions for clients and employees concerning claim-specific, procedural, or special requests, • Participate in customer claim reviews and presentations, • Ability to travel overnight and attend meetings if required, • Additional duties as assigned KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills, • Ability to assist team members to develop knowledge and understanding of claims practice, • Effective quantitative, analytical and interpretive skills, • Strong leadership, management and motivational skills, • Demonstrated, strong customer service skills, • Ability to maintain composure under pressure and communicate diplomatically across various channels, including telephone, email, and written correspondence, • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets, • Strong interpersonal, time management and organizational skills, • Ability to work both independently and within a team environment, • Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation EDUCATION & EXPERIENCE: • Bachelor's degree or a combination of education and related experience, • Demonstrated public speaking skills, • Minimum of 5 years’ claims handling experience, • Knowledge of WC required, • Current license or certification in Workers’ Compensation must be maintained throughout employment with CorVel, • Self-Insured Certificate preferred, • State Certification as an experienced Examiner 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: $71,696 - $110,701 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

Job Description The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Receives claims, confirms policy coverage and acknowledgment of the claim, • Determines validity and compensability of the claim, • Establishes reserves and authorizes payments within reserving authority limits, • Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision, • Communicates claim status with the customer, claimant and client, • Adheres to client and carrier guidelines and participates in claims review as needed, • Assists other claims professionals with more complex or problematic claims as necessary, • Additional duties as assigned KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills, • Ability to learn rapidly to develop knowledge and understanding of claims practice, • Ability to identify, analyze and solve problems, • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets, • Strong interpersonal, time management and organizational skills, • Ability to meet or exceed performance competencies, • Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: • Bachelor's degree or a combination of education and related experience, • Minimum of 1 year of industry experience and claims management preferred, • State Certification as an Experienced Examiner 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: $51,807 - $83,551 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

Job Description The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a Remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: • Expectation that Senior Claims Specialist maintain independent NY adjuster license as a casualty or general adjuster., • Receives claim, confirms policy coverage and acknowledgement of the claim, • Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies, • Establishes reserves and authorizes payments within reserving authority limits, • Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim, • Coordinates early return-to-work efforts with the appropriate parties, • Manages subrogation and litigation of claim as it applies, • Manages potential claim recoveries of all types, • Reports claims to the excess carrier when applicable, • Communicates claim status with the customer and claimant, • Adheres to client and carrier guidelines and participates in claims review as needed, • Develops and maintains professional customer relationships, • Complies with rules and regulations of applicable state, • Additional duties as assigned KNOWLEDGE & SKILLS: • Excellent written and verbal communication skills, • Ability to assist team members to develop knowledge and understanding of claims practice, • Ability to identify, analyze and solve problems, • Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets, • Strong interpersonal, time management and organizational skills, • Ability to work both independently and within a team environment, • Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation EDUCATION & EXPERIENCE: • Bachelor's degree or a combination of education and related experience, • Minimum of 3 years’ industry experience and claim handling, • Self-Insured Certificate preferred, • State Certification as an experienced Examiner 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: $59,681 - $96,123 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

Role OverviewMercor is collaborating with a top-tier AI research group to model real-world claims workflows for property and casualty insurance. We are seeking experienced independent contractors—particularly claims adjusters, examiners, and investigators—to execute and evaluate a wide range of P&C insurance tasks. This project supports the development of AI systems capable of understanding, simulating, and automating complex insurance operations. It is a short-term, high-impact engagement ideal for professionals with strong technical and compliance knowledge. Key Responsibilities - Execute full-cycle claims tasks including FNOL intake, coverage verification, reserve setting, and liability determination - Simulate real-world workflows using structured tools and mock systems such as Guidewire ClaimCenter and Xactimate - Review and synthesize third-party documentation including police reports, medical records, and vendor estimates - Draft structured outputs such as coverage memos, repair estimates, and liability assessments - Identify inconsistencies or red flags in claim statements and documentation - Evaluate claim compliance, document regulatory deadlines, and assess communication quality - Flag fraud indicators and recommend SIU referrals where applicable - Document all work clearly for auditability and quality review Ideal Qualifications - 5+ years handling property, auto, bodily injury, or general liability claims - Familiarity with systems such as Guidewire, Duck Creek, Xactimate, Hyland OnBase, or FileNet - Deep understanding of coverage interpretation, state compliance standards, and claims file documentation - Experience reviewing third-party documentation (e.g., police reports, medical summaries, contractor estimates) - Strong written communication and analytical skills More About the Opportunity - Remote and asynchronous — control your own work schedule - Expected commitment: min 30 hours/week - Project duration: ~6 weeks Compensation & Contract Terms - $100-150/hour - Independent contractor arrangement - Paid weekly via Stripe Connect Application Process - Submit your resume followed by domain expertise interview and short form About Mercor - Mercor is a talent marketplace that connects top experts with leading AI labs and research organizations - Our investors include Benchmark, General Catalyst, Adam D’Angelo, Larry Summers, and Jack Dorsey - Thousands of professionals across domains like insurance, law, engineering, and research partner with Mercor to shape the next era of AI

Role Overview Mercor is seeking experienced insurance underwriting professionals to collaborate with a technology-driven risk analytics partner. Freelancers will support the development and evaluation of automated insurance workflows, contributing expert insight to improve AI systems handling underwriting, risk assessment, and rating logic. This opportunity is ideal for professionals with property and casualty underwriting experience looking to apply their knowledge in a forward-looking, project-based environment. Key Responsibilities - Evaluate application data, loss history, and third-party reports (e.g., CLUE, MVR, LexisNexis) to determine underwriting acceptability. - Calculate insurance premiums using ISO manuals, class codes, and company-specific rating algorithms. - Analyze historical claims to assess loss trends and calculate loss ratios against industry benchmarks. - Draft policy terms and compile coverage documents including endorsements and declarations. - Review referred cases and provide documented decisions with clear rationale and risk treatment recommendations. Ideal Qualifications - 5+ years in commercial or personal lines underwriting, preferably with experience using platforms like Guidewire or Duck Creek. - Familiarity with ISO classification codes, rating manuals, and policy forms. - Strong attention to detail and ability to assess risk across various data inputs. - Proven track record of working with multi-line policies (property, auto, general liability). - Experience reviewing and interpreting third-party reports (CLUE, MVR, LexisNexis, etc.). More About the Opportunity - Remote and asynchronous — control your own work schedule - Expected commitment: min 30 hours/week - Project duration: ~6 weeks Compensation & Contract Terms - $50-80/hour - Independent contractor arrangement - Paid weekly via Stripe Connect Application Process - Submit your resume followed by domain expertise interview and short form About Mercor - Mercor is a talent marketplace that connects top experts with leading AI labs and research organizations. - Our investors include Benchmark, General Catalyst, Adam D’Angelo, Larry Summers, and Jack Dorsey. Thousands of professionals across domains like law, creatives, engineering, and research have joined Mercor to work on frontier projects shaping the next era of AI

Mercor is seeking highly qualified Medical Experts with strong clinical knowledge and excellent analytical skills to support a high-impact AI research initiative in partnership with a leading AI lab. In this role, you will evaluate and audit AI-generated medical outputs across a wide range of clinical and scientific tasks, ensuring accuracy, safety, and adherence to medical standards. * * * ## Key Responsibilities - Review and audit AI-generated medical content, including clinical explanations, differential diagnoses, treatment recommendations, research summaries, and patient-facing materials. - Evaluate medical text quality using structured rubrics (8–10 criteria), focusing on accuracy, evidence alignment, clarity, and risk/safety considerations. - Verify correctness of clinical reasoning, identifying logical gaps, unsafe recommendations, or unsupported claims. - Assess adherence to medical guidelines, best practices, and standard terminology. - Identify errors related to medical facts, pathophysiology, pharmacology, contraindications, or misinterpretation of clinical data. - Provide clear, concise written feedback to justify evaluation decisions. - Work independently and asynchronously using provided tools and workflows. * * * ## Qualifications - Advanced medical training (MD, DO, RN, PA, NP, clinical researcher, or equivalent background). - Strong understanding of clinical reasoning, diagnostic process, and evidence-based practice. - Experience in one or more of the following: - Clinical writing or reviewing - Medical education or exam preparation content - Research interpretation and summarization - Healthcare quality review or medical annotation tasks - Exceptional attention to detail and ability to follow complex guidelines. - Ability to work independently in a remote environment. * * * ## Role Details - Part-time: 30–40 hours per week - Fully remote and asynchronous - Flexible scheduling * * * ## Compensation - Contractor role via Mercor - $80–$100/hour, depending on experience - Weekly payments through Stripe Connect * * * ## About Mercor Mercor is a San Francisco–based company connecting top professionals to cutting-edge AI initiatives. Our investors include Benchmark, General Catalyst, Adam D’Angelo, Larry Summers, and Jack Dorsey. We partner with leading AI labs to accelerate innovation through high-quality human evaluation.

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose.Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence.Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview ROLE SPECIFICS: • Jurisdictions: New York, • Licenses: NY adjusters license required, • Location: This role is eligible for fully remote work. How you'll make an impact • Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims., • Interact extensively with various parties involved in the claim process to ensure effective communication and resolution., • Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process, • Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements., • Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file. About You Ideal candidates for this position will have: • Claims Background: Minimum of 3-5 years of hands-on workers compensation adjusting experience required including handling a lost-time desk and litigation., • Jurisdictional Experience: NY claims experience required., • Active Adjusters' licenses: NY adjusters license required. As a key member of our experienced Claims Adjuster team, you will: • Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution, • Work in partnership with our clients to deliver innovative solutions and enhance the claims management process, • Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants REQUIRED QUALIFICATIONS: • High School Diploma., • Minimum of 5 years related claims experience., • Appropriately licensed and/or certified in all states in which claims are being handled., • Knowledge of accepted industry standards and practices., • Computer experience with related claims and business software. DESIRED: • Bachelor's Degree, • 3+ years of claims experience. #LI-HS1 #LI-Remote #GBWCLinkedInCampaign Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: • Medical/dental/vision plans, which start from day one!, • Life and accident insurance, • 401(K) and Roth options, • Tax-advantaged accounts (HSA, FSA), • Educational expense reimbursement, • Digital mental health services (Talkspace), • Flexible work hours (availability varies by office and job function), • Training programs, • Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing, • Charitable matching gift program We value inclusion and diversity ___ to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

Workers Compensation Claims Team Lead.By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your career with us, experience our caring culture, and enjoy work-life

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Develop strategic partnerships between the health plan and the contracted provider networks serving our communities. Cultivate client relations and collaborate with providers to ensure delivery of the highest level of care to our members. Participate in the development of network management strategies. Creates strategic initiatives for performance improvement. * Conducts regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices * Focuses on value-based care model initiatives, collaborating with physicians to identify and align to performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care * Uses data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets * Builds strong interpersonal relationships with cross functional teams both externally (provider) and internally (health plan)-C-suite Level * Expert proficiency in tools and value-based performance (VBP) in order to educate providers resulting in improved provider performance * Resolves provider issues as needed for resolution to internal partners and creating efficiencies to prevent continued concerns * Receive and effectively respond to external provider related issues * Investigate, resolve and communicate provider high dollar and high volume provider claim issues and changes * Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics * Evaluates provider performance and develops strategic plan to improve performance * Present detailed HBR analysis and create reports for Joint Operating Committee meetings (JOC) * Acts as a lead for the external representatives * Coaches and trains external representatives * Ability to travel locally 4 days a week * Performs other duties as assigned * Complies with all policies and standards Education/Experience: Bachelor’s degree in related field or equivalent experience. Master's Degree preferred in Public Health (MOH), Health Administration (MHA) or Business Administration (MBA).: Five or more years of managed care or medical group experience, provider relations, quality improvement, utilization management, or clinical operations. Project management experience at a medical group, IPA, or health plan setting. Executive level exposure and ability to influence desired outcomes, innovation, performance, member improvements, growth and Provider retention Ability to synthesize complex issues at multiple organizational levels, externally and internally across multi-disciplinary teams. Highly proficient in HEDIS/Quality measures, cost and utilization.Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Researches simple to complex claims payments using tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate overpayments made to providers. Supports claims department initiatives to

Job Category: Claims Description The Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. Assesses policy coverage for submitted claims and notifies the

Accounts Receivable / Remote] - Anywhere in U.

Accounting & Finance Support / Remote] - Anywhere in U.

Accounts Receivable / Accounts Payable / Remote] - Anywhere in U.

Accounts Receivable / Remote] - Anywhere in U.

Accounting & Finance Support / Remote] - Anywhere in U.

OfficeTeam - JobID: 02920-0013352110-usen [ Office Team by Robert Half leverages its strong relationships with hiring managers across the globe to not only help you find work, but also coach you through the interview process and provide long-term resources to you while ensuring you top pay, great be

Accounts Receivable / Remote] - Anywhere in U.

Accounting & Finance Support / Remote] - Anywhere in U.

Accounts Receivable / Remote] - Anywhere in U.

Accounts Receivable / Accounts Payable / Remote] - Anywhere in U.

If you work remotely, there is no commute. This is an excellent opportunity to earn a side income by doing flexible remote work from home.

Accounts Receivable / Accounts Payable / Remote] - Anywhere in U.

Customer Care Center Representative.Carrier, global leader in intelligent climate and energy solutions, is committed to creating innovations that bring comfort, safety and sustainability to life.Through cutting-edge advancements in climate solutions such as temperature control, air quality and trans

MCI organically grows, acquires, and operates companies that have synergistic products and services portfolios, including but not limited to Automated Contact Center Solutions (ACCS), customer contact management, IT Services (IT Schedule 70), and Temporary and Administrative Professional Staffing (T

Minimal weekday hours required (join for weekends only!).NO LIMIT * Additional terms and conditions apply.Competitive hourly pay rates & team bonus.At David's Bridal, we empower our customers and our employees to stay true to their dreams and find the one, whether that means the wedding dress that m

Responsible for receptionist activities as well as patient insurance verification.Gather patient information by taking initial demographic information from rental source and document on Patient Information Sheet/computer system.Verify all types of insurance and assist in creative financing when no i

Customer Service Representative.Are you a people person? Do you love helping others? U-Haul is in search of friendly, motivated people for the position of Customer Service Representative.As a Customer Service Representative, you will work as part of a supportive team to be the face of U-Haul company

Customer Service Representative.We want you to join our team as a Customer Service Representative.If you have the desire to be challenged, work in a fast-paced, fun environment and to grow your career - look no further.As a Customer Service Representative, you will enjoy:.Medical, Vision, Dental, &

Responsible for supporting real estate transactions by providing a range of administrative and/or support duties to assist title processes as part of a production center, branch office, or member of a title team.Performs centralized clerical processing of documents related to accurate and timely tit

Customer Service Representative.We are a global leader in the design, manufacture, and distribution of ophthalmic lenses, frames, and sunglasses.We offer our industry stakeholders in over 150 countries access to a global platform of high-quality vision care products such as the Essilor brand, with V

Customer Service Representative.We want you to join our team as a Customer Service Representative.If you have the desire to be challenged, work in a fast-paced, fun environment and to grow your career - look no further.As a Customer Service Representative, you will enjoy:.Medical, Vision, Dental, &

Minimal weekday hours required (join for weekends only!).NO LIMIT * Additional terms and conditions apply.Competitive hourly pay rates & team bonus.At David's Bridal, we empower our customers and our employees to stay true to their dreams and find the one, whether that means the wedding dress that m

Customer Service Representative.We want you to join our team as a Customer Service Representative.If you have the desire to be challenged, work in a fast-paced, fun environment and to grow your career - look no further.As a Customer Service Representative, you will enjoy:.Medical, Vision, Dental, &

Customer Service Representative (Temp-to-Hire).Duration: 6 months (Temp-to-Hire) Start Date: Immediate Work Location: 100% Onsite East Syracuse, NY 13057 Schedule: MondayFriday | 10:30 AM 7:00 PM EST.The Customer Service Representative provides high-quality, multi-channel customer support through

Welcome to Gerber Collision & Glass.Gerber Collision & Glass is one of the largest collision repair companies in North America.With $3+ billion in sales, over 1000 locations and growing, our 10,000+ team members across the United States and Canada are passionate about delivering our goal to WOW Ever

Analyst, Claims Research serves as a senior-level subject matter expert in claims operations and research, leading the most complex and high-priority claims projects. The Senior Claims Research Analyst provides senior-level support for claims processing and claims research. Act as a senior claims su

Customer Service Representative - Liverpool, NY.Attention Military Affiliated Job Seekers.Our organization works with partner companies to source qualified talent for their open roles.The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Militar

Now, we're expanding our nationwide remote team and seeking individuals who want meaningful, long-term careers not just another sales role. Self-motivated and reliable in a remote work setting. Remote Flexibility: Design your own workspace and schedule.

Answer customer calls and correspondence regarding new or existing insurance policies and service all claims.

Car Wash Customer Service Representative.Monday - Friday 7:30am - 4:00pm.Hoffman Car Wash is a fast-growing car wash dedicated to providing excellent service and outstanding customer experience.We take pride in our teamwork, attention to detail, and commitment to keeping every vehicle looking its be

Under the direction of the Supervisor of Customer Service, this position resolves customer inquiries via telephone, email, walk-in, and mail regarding plan benefits, claim payments and denials, and eligibility in accordance with custom designed benefit plans.This will be done in a polite, profession

County Waste in Clifton Park is looking to add a Customer Service Representative to our growing team!.Our priority is to make sure we hire professional customer service representatives that care about the safety of our drivers and the service provided to the community.As a customer service represent

Candidate will be responsible for following up on medical claims including but not limited to follow up on claim submissions, investigating patient accounts, resolving denials, and fielding all incoming correspondence.