Clinical Review Auditor I
CorVelFort Worth, Texas, United States
Posted April 15, 2026
70443 - 107253 USD
Full Time
About the Company
CorVel Brand is a leading national claims management and managed‑care provider, delivering comprehensive risk‑management solutions for workers’ compensation, medical billing, and liability claims. With more than 30 years of industry experience and annual revenues exceeding $896 million, the company blends local customer service with robust national resources and continuous investment in technology and talent. Its portfolio includes workers’ compensation, medical bill review, case management, PPO and pharmacy benefit management, telehealth, and return‑to‑work programs, positioning CorVel as a one‑stop partner for employers, insurers, and healthcare providers. The firm’s publicly traded status (NASDAQ:CRVL) and commitment to data‑driven analytics enable it to produce measurable outcomes and cost efficiencies for clients.
Job Description
The Clinical Review Auditor I will perform DRG validation reviews of medical records, determine correct DRG/coding, and provide clinical/policy/regulatory support. The ideal candidate has strong written and verbal communication skills, clinical knowledge, and understanding of medical necessity rules.
Requirements
- Review medical records to determine accuracy of billing
- Conduct audits to ensure accurate reimbursement and identify potential savings
- Demonstrated knowledge of ICD-10-CM codes, PCS and DRG coding, payer rules and regulations
- Understand and comply with all internal and external policies
- Assist Quality Control team and medical director with appeals, rebuttals, etc.
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
