3 associate ii jobs found in Folsom

The Field Data Specialist gathers, organizes, packages, and presents operational data and translates the numbers into a consumable format.   Enters data from various source documents into the computer system for storage, processing, and data management purposes. This is a remote position. Essential Functions & Responsibilities:  ·        Supports and contributes to data collection efforts Supports and partners with team members and management across departments and units Runs delivered reports as needed Enters data from source documents into prescribed computer database, files and forms Ensures quality and consistent data collection Reviews large sets of data and may break down into desired final output Packages and present data, both client-facing and for internal communication V erifies data and facilitates corrections when necessary Manages data request intake queue; responds timely to requests for information...

The Quality Assurance Nurse is responsible for case management quality assurance and mentorship of operations staff, providing tools and calibrating processes, while ensuring consistent delivery of CorVel’s case management services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Develop, implement, and provide ongoing quality assurance calibration of processes as well as a case management mentoring, both managed and delivered at the operational level Educate and equip operations with performance measurement and reporting tools that can be used to objectively measure and grow operations Provide national account and regulatory quality oversight As applicable, provide oversight and management of URAC compliance and renewals Work with executive, general and case management department management to ensure the case management department successfully implemented and is adhering to CorVel standards (including quality assurance, reporting, and...

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 position. 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...