At the Heart of Claims Management: It’s the People

Happy group of coworkers standing around desk collaborating on claims management

Results matter.

CorVel’s consistent client retention is a testament to the satisfaction clients find in the company’s services. But it means much more than that. It signifies CorVel’s commitment to tapping into state-of-the-art technology while prioritizing the people behind the technology—the claims professionals—who are crucial to a successful claims process.

Claims professionals are trained to work hand-in-hand with clients to ensure that claims are resolved quickly, accurately, and with the best possible results for clients and workers alike.

CorVel’s claims professionals share a mission to ensure that injured workers are promptly provided with the best care and the opportunity to return to work, while reducing claims costs overall.

Industry Leader

An insight into CorVel’s performance comes from an industry comparison, evaluating our results alongside those of other third-party administrators.

A recent comparison showed a 4.2% improvement in CorVel’s closure rates compared to carrier benchmarks, and we achieved a 27% decrease in indemnity paid and a 20% decrease in medical costs paid.

This demonstrates CorVel’s commitment to generating meaningful client results, including quicker claims closures, reduced litigation, and lower overall costs. The company’s successes are due, in great part, to the claims professionals who are at the heart of everything CorVel does.

Overcoming the Talent Gap

Industries throughout the U.S. are facing a talent shortage, and risk management is no exception. CorVel’s efforts to address labor challenges and to retain claims professionals means paying attention to what’s important to them. CorVel provides ongoing employee training to ensure that everyone involved in the claims process has the knowledge and know-how to perform their jobs. We also empower claims professionals with the latest technology and advanced tools to provide outstanding customer service and show employees they are valued and appreciated.

CorVel University

CorVel University is a comprehensive national training initiative tailored for entry-level candidates aspiring to build a career in the claims industry. This program is designed to equip the next generation of claims professionals with essential skills and knowledge, positioning them for excellence across various jurisdictions. With a detailed curriculum covering all facets of claims management, the program’s key strengths lie in the presence of knowledgeable CorVel instructors who bring industry expertise and practical experience to the training sessions. This initiative exemplifies CorVel’s dedication to delivering exceptional service while fostering employee retention and professional growth.

People First at CorVel

CorVel’s mission is to provide clients with the best possible service and outcomes, and we recognize that claims professionals are crucial to that goal. Advanced technology is integral in the process, but the people are what makes everything happen.

Helping employees stay happy and engaged in their work is all part of a greater strategy that results in a better claims process for all involved. Some of the initiatives CorVel utilizes to retain employees include:

  • Bonus Program
    CorVel offers a bonus program that incentivizes claims professionals to achieve claims quality excellence based on such factors as carrier compliance, successful audits, and client satisfaction.
  • Loyalty Program
    Employees who attain specific benchmarks during their tenure at CorVel receive gifts and recognition for their commitment to the company.
  • Claims Appreciation Week
    A week of special events recognizes our claims staff to ensure they know they are valued and appreciated.
  • Work-Life Balance
    CorVel’s indemnity claims specialists across the nation average 125 cases, which ensures they aren’t getting burnt out, feel refreshed, and can pay greater attention to the details of every claim, all of which generates better results for clients.
  • Leadership Program
    CorVel’s leadership program empowers CorVel professionals with leadership skills, a deep understanding of the company’s culture, and opens doors for advancement within the organization. It exemplifies CorVel’s dedication to nurturing its talent and fostering a culture of continuous improvement.


The Impact on Claims Quality

CorVel specialists are trained to provide exemplary service throughout handling and resolving claims—a process dubbed “claims quality.” What does that entail? It starts with being proactive rather than reactive. CorVel’s standard is for claims professionals to initiate contact within 24 hours of the claim assignment. Taking this proactive approach, CorVel’s claims professionals identify opportunities for workers to return to work, provide the right care at the right time, and avoid costly litigation.

Claims quality also means a thorough investigation of new claims, including identifying whether an injury is compensable under the Workers’ Compensation Act, seeking reimbursement from whoever is at fault for an accident, and investigating collateral sources. CorVel’s claims professionals are trained to adhere to state, federal, and local claims administration guidelines. As another tenant of CorVel’s best practices, they also follow clients’ special handling practices.

Claims Excellence Tracker

Claims specialists’ files are audited on a monthly basis, which ensures that claims are being handled in accordance with CorVel’s best practices, that specialists are investigating and responding to all aspects of a claim, and are providing the best claims quality possible. Throughout this comprehensive audit process, multiple levels of review are engaged, including supervisors, managers, and a dedicated quality assurance manager.

Operational Excellence

CorVel’s operational excellence is supported by an extensive suite of reports designed to elevate our claims handling beyond our clients’ expectations. These reports serve as a comprehensive toolset, enabling us to confirm compliance at every stage of the claims process. From initial contacts to the execution of initial and subsequent plans of action, including prompt CareMC Edge® alert actions, these reports empower us to maintain operational excellence consistently on a national scale. This holistic approach ensures that potential risks are identified and addressed throughout the entire claims lifecycle.

By upholding a meticulous approach, our claims professionals leave no stone unturned, ensuring comprehensive attention to every facet of the claim. This dedication underscores our commitment to delivering the highest standard of claims quality, while also being responsive to all parties involved, including clients, insurance carriers, physicians, and injured workers.

In Tandem with Tools and Technology

Providing claims professionals with the tools they need to succeed is a crucial part of CorVel’s mission and also helps employees stay engaged and work to their optimal levels. CorVel’s early intervention model impacts the trajectory of a claim, resulting in fewer high-severity claims, more first-aid incidents that are quickly resolved, and overall enhanced claims quality. Advocacy 24/7 nurse triage and telehealth services provide care immediately and without geographical constraints, further streamlining the claims process. Virtual care enables proactive claims handling, and CareMC Edge®, CorVel’s integrated claims management platform, provides claims professionals with immediate access to invaluable information the moment they receive the claim.

Advocacy 24/7

Injured workers receive the right care at the time of the incident. Over 45% of callers qualify for first aid/self-care instructions. If more advanced care is needed, they are sent promptly to the appropriate providers, whether they require telehealth or an in-person visit with a healthcare provider. All communications with the worker are uploaded and documented in real time to the claim. The worker’s preliminary statement is quickly documented, enabling faster evaluation of red flags, potential hurdles, and severity.

63% decrease in litigated claims, 31% decrease in cost per claim, 26% decrease in days open

Virtual Care

Telehealth has gained prominence in recent years, and CorVel’s virtual care services expedite treatment and provide real-time information in the claims system, including work restrictions, requests for treatment, injured workers’ questions, and other pertinent information.

CareMC Edge®:
Advanced Claims Technology

CorVel operates its claims system on a single platform, ensuring seamless integration and communication among all services. This simplicity and comprehensive approach empower claims professionals to work more efficiently, allowing them to focus on the critical drivers of claims costs. The outcome is reduced claims costs, minimized litigation, and improved outcomes.

CareMC Edge®’s intuitive interface complements this by identifying potential cost drivers and challenges in claims, directing specialists to specific cases for review, and recommending actions to address risks. Through streamlined tasks, reduced manual work, and automated processes, CorVel facilitates a focus on complex, value-added tasks, promoting professional growth and job satisfaction for claims staff. Integrating artificial intelligence and machine learning further enhances data analysis, empowering claims professionals to make informed decisions and boost productivity. This holistic approach underscores CorVel’s commitment to efficiency, cost reduction, and optimal claims management results.

Risk Score

Leveraging artificial intelligence and predictive analytics, this innovative feature assesses diverse data elements on a claim, including return-to-work estimates, physical demand requirements, pain levels, claimant medical compliance, comorbidities, claim history, age, and psycho-social indicators. The resulting risk evaluation equips claims professionals with information and details as to which claims may become outliers relative to their peers, along with unparalleled insights, enabling proactive intervention from day one. This strategic integration aligns seamlessly with our dedication to delivering the highest standard of claims quality while effectively managing risk factors throughout the entire claims lifecycle.

Severity Scorecard

A quick flagging system in CareMC Edge® spurs examiners to identify whether a claim has a low, medium, or high potential for increased severity. It prompts claims professionals to pay extra attention to the claims with high scores.

Supervisor Dashboard

Supervisors receive proactive alerts to identify claims with potential exposures or risks, leveraging a second set of experienced eyes to ensure claims stay on course. This oversight ensures that potential risks or exposures in a claim are promptly and thoroughly addressed. The Supervisor Dashboards are equipped with tracking and reporting functions, essential for claims executives and risk managers who understand the importance of measuring and demonstrating results. These functions provide valuable insights into whether a new initiative is effectively influencing claim trends.

Generative AI

CorVel’s generative AI module revolutionizes claims processing by rapidly summarizing medical data, proposing actions, and automating data extraction. Integrated into CareMC Edge®, this innovative tool addresses labor-related challenges, guiding claims professionals and amplifying their effectiveness. By boosting efficiency, Generative AI gives specialists more time to focus on what matters most in the claims process—the human touch.

This commitment to cutting-edge technology reflects CorVel’s dedication to claims staff success, creating an innovative and attractive workplace for industry professionals. Moreover, better data analysis and faster decision-making through these tools drive improved outcomes from both clinical and cost perspectives.

Staying the Course

While the labor shortage is hitting all industries, CorVel remains committed to ensuring that its people remain at the heart of the claims process and continue to add value and exceed client expectations.

CorVel stands out as an industry leader, not only due to our advanced technology but also through comprehensive training programs and employee recognition initiatives. The impact is reflected in reduced claims costs, minimized litigation, and overall improved outcomes. By creating a workplace culture that values innovation and prioritizes the well-being of its claims staff, CorVel delivers exceptional results and attracts and retains top talent in the industry.

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