Appeals Team Lead

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.ESSENTIAL FUNCTIONS & RESPONSIBILITIES:Receive incoming calls, emails and faxes from the Medical Access Assistant lineCommunicate clearly and professionally with providers and other stakeholders via phone and emailProvide excellent customer service and act as network liaison to injured workers, claims examiners and providersUnderstand Workers Compensation guidelines and various client contract language to interpret and support our bill reviewNavigate the bill review application to obtain accurate information for the callersTriage requests and ensure they are completed within required timeframesLocate providers of a particular specialty within a designated area as requested by the callerVerify providers are within a specified network and/or have a contract with CorVelSchedule appointments for injured workers upon requestAssist callers in navigating our website directoryCall providers to verify demographic information (address, phone number, WC acceptance, etc)Answer questions from callers regarding their MPN; transferring the caller to the appropriate department if we are unable to assistWork with the Network Relations team to correct any discrepancies in the databaseCommunicate to the contract developers if there is a need for certain specialties in a geographic areaUnderstand CorVel EORs as well as client-specific nuancesAnswer basic to complex State WC fee schedule and/or billing questions on processed medical bills covering regular as well as facility bill typesUnderstand and be able to properly explain provider contracted rates, and carve-outs applied to medical billsAdditional duties as assignedKNOWLEDGE & SKILLS:Excellent oral and written communication skillsWorking knowledge of Microsoft Office (Word, Excel)Strong knowledge of fee schedule and network contractsStrong customer service skills and experienceStrong organizational skillsAbility to work independently and in a team environmentEffective quantitative, analytical and interpretive skillsStrong interpersonal, time management and analytical skillsAbility to control phone calls to ensure timely resolution and lower provider hold timesEDUCATION & EXPERIENCE:Associates' degree preferred or comparable Workers Comp experienceKnowledge of assigned State's Workers' Comp regulationsCPC and/or expert in bill review analysis preferredCall center experience a plus but not requiredPAY 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 hourA list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk ManagementIn 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 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.

Created: 2026-04-02