5 client services analyst i jobs found in Folsom

The Bill Review Analyst is responsible for reviewing, auditing and data-entry of medical bills for multiple states and lines of business. This is a remote position ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts May consult reference materials in the auditing process Based upon situation or state-specific cases, meet 98% accuracy, 10,000+ keystrokes per hour Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of medical terminology, workers’ compensation billing guidelines and fee schedules Knowledge of CPT/ICD/HCPS coding Knowledge of UBO4/DWC-9/DWC-10 and CMS 1500 form types preferred Strong interpersonal skills and commitment to customer service Ability to work independently and in a team environment Ability to identify problems and find effective...

The WC 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 position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives   Workers’ Compensation  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...

The WC 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 position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives   Workers’ Compensation  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...

The Provider Relations Specialist assists providers via phone and email with bill review questions and requests of varying complexity. 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 consistent, timely delivery of our quality services. This role may be transitioned into a Knowledge Center Representative role within the first year of employment, based on business needs. While both the Provider Relations Specialist and the Knowledge Center Representative roles are customer support roles with overlapping core functions, specific responsibilities pertaining to only the Knowledge Center Rep role are marked as such in the below job description. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate clearly and...

The Claims Training Specialist is responsible for developing curricula to ensure adherence to CorVel’s best practice guidelines, special customer handling requirements, improve quality of audit metrics and overall claims outcomes. This includes ensuring that a designated geographical claims area of CorVel is equipped with an Operations workforce that can optimize its current and future goals and objectives, and deliver quality services that can meet our clients’ requirements and service expectations.  In order to efficiently execute daily responsibilities, the Claims Training Specialist must first obtain a deep understanding of the business to articulate what our claims model does and to clearly demonstrate all aspects of the Operations roles in order to be able to successfully conduct and oversee the department training.   Other duties to be carried out by Claims Training Specialist will include conducting classroom, virtual, and field training to internal employees/colleagues,...