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Remote Case Reviewer Jobs in Colorado (NOW HIRING)

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Remote Case Reviewer information

What are the key skills and qualifications needed to thrive as a Remote Case Reviewer, and why are they important?

To thrive as a Remote Case Reviewer, you need strong analytical skills, attention to detail, and relevant professional credentials, often in fields like healthcare, insurance, or law. Familiarity with case management software, electronic documentation systems, and industry regulations (such as HIPAA for healthcare) is typically required. Excellent written communication, time management, and independent decision-making are standout soft skills for this role. These abilities ensure accurate, compliant, and efficient case evaluations while maintaining high-quality standards in a remote work environment.

What is the difference between Remote Case Reviewer vs Remote Claims Processor?

AspectRemote Case ReviewerRemote Claims Processor
Required CredentialsHigh school diploma or equivalent; healthcare or legal background often preferredHigh school diploma or equivalent; experience in insurance or claims processing beneficial
Work EnvironmentHome-based, independent review settingHome-based, processing insurance claims
Industry UsageHealthcare, legal, insurance sectorsInsurance companies, third-party administrators
Common Search/ComparisonRemote Case Reviewer vs Remote Claims Processor

While both roles are remote and involve handling cases or claims, Remote Case Reviewers primarily evaluate and assess cases, often requiring specialized knowledge in healthcare or legal fields. Remote Claims Processors focus on processing insurance claims, verifying information, and ensuring accurate payment. Understanding these differences helps job seekers identify the role that best matches their skills and career goals.

What are some common challenges Remote Case Reviewers face, and how can they effectively manage them?

Remote Case Reviewers often encounter challenges such as managing a high volume of cases, staying organized with digital documentation, and maintaining clear communication with team members across different locations. To address these, it's important to develop strong time management skills, utilize standardized review checklists, and take advantage of collaboration tools like secure messaging platforms. Regular virtual meetings and clear protocols help ensure consistency and quality, while ongoing training can keep reviewers up to date on best practices.

What are remote case reviewers?

Remote case reviewers are professionals who assess and evaluate cases, such as medical, legal, or insurance files, from a remote location rather than working on-site. Their responsibilities typically include reviewing documentation, ensuring compliance with policies and regulations, and providing recommendations or decisions based on their findings. Remote case reviewers use secure digital platforms to access and analyze case materials, enabling flexibility and efficiency in their work. This role can be found in industries like healthcare, law, insurance, and finance. Strong attention to detail and analytical skills are essential for success in this position.
What are popular job titles related to Remote Case Reviewer jobs in Colorado? For Remote Case Reviewer jobs in Colorado, the most frequently searched job titles are:
Child and Family Services Administrative Reviewer

Child and Family Services Administrative Reviewer

State of Colorado

Denver, CO • On-site, Remote

$5.9K - $9.5K/mo

Other

Posted 10 days ago


State Of Colorado rating

7.3

Company rating: 7.3 out of 10

Based on 91 frontline employees who took The Breakroom Quiz

35th of 50 rated states


Job description

Department Information This position is open to current Colorado residents only. Please note: This recruitment may be used to fill multiple vacancies. About this Unit: The Administrative Review Division's (ARD) vision is to create a safe and promising future for children and at-risk adults.

Our mission is to strengthen the communities, families, and systems that work to make that future possible. As a neutral, third party, we do this by facilitating reviews, gathering and analyzing data, publishing research, and providing training and technical assistance to effect change in practice, policy, and programs that lead to improved outcomes for Colorado's children and at-risk adults. Colorado's Administrative Review Division (ARD) serves as an independent third party review system under the auspices of the Colorado Department of Human Services.

The ARD manages quality assurance and quality improvement programs for Colorado's child welfare and adult protective services systems. Specifically, the ARD is the mechanism responsible for the federally required Case Review System and a portion of the Quality Assurance System for both the Division of Child Welfare and the Division of Youth Services. Additionally, the ARD conducts quality assurance reviews of Adult Protective Services cases.

With an ultimate passion of providing permanency and well-being for Colorado's children, and the safety and protection of at-risk adults, the Administrative Review Division works closely with Colorado's counties to train, measure and assess their adherence to State and Federal regulations. Such regulations are in place to help prevent unnecessary moves for children in foster care and to assess (and encourage) that the needs of the families', children, and at-risk adults are being appropriately addressed. Specifically, the ARD is the mechanism responsible for: Child Welfare Quality Assurance: The federally required child welfare Case Review and Qualitative Case Review systems, Administrative Reviews Court ordered substituting Administrative Reviews Screen Out Reviews/Assessment Reviews In-home Services Case Reviews Institutional Abuse/Neglect Reviews Colorado's statutorily mandated Child Fatality Review Team Foster Home Certification Reviews Child Welfare Hotline Reviews Adult Protective Services Quality Assurance: Adult Protective Services qualitative case reviews Child and Adult Maltreatment Dispute Review Section Child abuse and neglect dispute review unit Adult Protective Services dispute review unit Qualified Residential Treatment Program Placement Review Description of Job PLEASE NOTE: This position follows a hybrid work arrangement, combining remote work with regular travel.

The employee will maintain a home office located within 20 miles of the Colorado Department of Human Services (CDHS) offices at 1575 Sherman Street, Denver, CO 80203. Candidates are preferred to reside in the following counties within the Denver metro region: Denver County, Broomfield County, Northern Jefferson County, Western Adams County, and Southern Boulder County. The ideal home location is north of Interstate 70 (I-70), east of the foothills corridor served by the major highways such as Interstate 25 (I-25) and Interstate 76 (I-76) within this metro zone, and no further east than Denver International Airport.

These major transportation routes support the frequent travel requirement throughout the assigned counties. Please note: These working arrangements are subject to change About this Position: Provides independent third party review and quality improvement processes for the Division of Child Welfare (CW) and the Division of Youth Services (DYS) service delivery. These reviews and quality assurance processes include: Administrative Reviews, Court-ordered Substituting Administrative Reviews, Quality Assurance Reviews (including reviews of child protection assessments and in-home service cases), Child and Family Services Reviews Ad-hoc reviews, and IV-E eligibility reviews to maximize Title IV-E revenue and ensure that court orders contain federally required language.

Qualitative Case Reviews: Responsible for conducting periodic Administrative Reviews for children every six months they are in care, and Administrative Permanency Reviews every 12 months children are in out-of-home (foster) care per CRS 19-2- 906.5 and 19-3-702. This process involves collecting, analyzing, interpreting and summarizing data gathered through the file read and personal interview. Based on the data collected, a determination will be made as to the compliance or non-compliance with Federal and State regulations that govern all children and youth in the custody of the county department of human/social services or Division of Youth Services

Recommends administrative response and/or sanctions for non-compliance. This position will also conduct reviews of child welfare assessments as well as cases involving the provision of in-home services. This position will also participate in the Child and Family Services reviews.

Reviews occur in the county departments. Each CI-II staff is assigned to a number of counties and will travel daily to these different counties in order to conduct reviews. Approximately 6-8 over-night stays may be required per month.

Training and Technical Assistance: Communicates with and influences a variety of county, region, court, State Program and other state staff in order to address case specific and systemic issues. This involves providing case specific technical assistance as well as larger trainings on systemic issues. Contact Reviewer and other duties as assigned: Specific to assigned counties, this position is in charge of scheduling review staff to cover the assigned counties in their geographic area.

This includes determining the necessary number of reviews days required by each county in order to remain in compliance with Federal requirements of timely periodic reviews, securing appropriate resources (county space, computers, etc.), communicating and altering schedules with other review staff, etc. Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights Experience Only: Six (6) years of relevant experience in an occupation related to the work assigned to this position. Must have two (2) years of professional human services investigative experience conducting child and/or youth abuse and neglect investigations, provision of ongoing child protection and/or youth services, or supervision of professional social caseworkers in child protection and/or youth services

Experience must demonstrate working knowledge and experience utilizing Volume VII Regulations and the Colorado Children's Code, and Colorado child welfare processes. AND Two years of relevant experience including ongoing permanency casework and/or intake and assessment casework. OR Education and Experience: A combination of related education and/or relevant experience in an occupation related to the work assigned equal to six (6) years.

Experience must include two (2) years of professional human services investigative experience conducting child and/or youth abuse and neglect investigations, provision of ongoing child protection and/or youth services, or supervision of professional social caseworkers in child protection and/or youth services. Experience must demonstrate working knowledge and experience utilizing Volume VII Regulations and the Colorado Children's Code, and Colorado child welfare processes. AND Two years of relevant experience including ongoing permanency casework and/or intake and assessment casework.

Preferred Qualifications Minimum of 1 year experience with Colorado Trails or other relevant SACWIS systems Ability to read and evaluate multiple volumes of typed and/or hand-written case materials on a daily basis; and Possess intermediate computer skills to enter information into various databases, produce reports, and email information to colleagues and others. Strong preference will be given to candidates with 3-5 years of experience conducting child and/or youth abuse and neglect investigations, provision of ongoing child protection and/or youth services, or supervision of professional social caseworkers in child protection and/or youth services. Strong preference will be given to candidates who possess a bachelor's degree in any of the fields listed in the Minimum Qualifications section of this announcement.

Certified through the Child Welfare Training Academy Experience supervising child welfare caseworkers conducting assessments or on-going service delivery. Exceptional communication skills, including demonstrated success in developing curriculum and providing training utilizing adult learning theory. Candidates are preferred to reside in the following counties within the Denver metro region: Denver County, Northern Jefferson County, Western Adams Country and Southern Boulder County.

The ideal home location is north of Interstate 70 (I-70), west of Denver International Airport (DIA) and east of the foothills corridor served by major highways such as Interstate 25 (I-25) and Interstate 76 (I-76) within this metro zone. These major transportation routes support the frequent travel requirement throughout the assigned counties. Highly Desirable Knowledge, Skills, and Abilities: Demonstrated working knowledge and understanding of federal and state law and how it applies to the administrative review process; Knowledge and ability to provide technical expertise and training regarding the Adoption and Safety Families Act (ASFA) and federal mandates to insure that all orders issued by the courts within the district contain the federally required findings in order to maximize Title IV-E funding for children and families served by county departments and regions; Ability to conduct reviews which may substitute for court reviews, and work directly with the county to develop and operate a combined Administrative Review 6-month periodic review process; Ability to act as a liaison between the judicial district, county department, region, and state; Ability to manage scheduling needs of multiple counties and multiple reviewers to ensure reviews are completed timely; Ability to manage and resolve conflicts, confrontations, and disagreements in a positive and constructive manner to minimize negative personal impact; Ability to derive logical conclusions from available information, utilizing a combination of judgment and formal guidance, in order to determine if departmental objectives have been met; Ability to effectively communicate in both written and oral format to prepare and present review findings and provide technical assistance; Ability to set and prioritize workload, identify short- and long-term goals and develop strategies to achieve them; and Ability to negotiate to find mutually acceptable solutions, and builds consensus through give and take.

Conditions of Employment Full background check and reference check required This position requires State of Colorado residency at the time of application, and residency within the state throughout the duration of employment in this position. Candidates are preferred to reside in the following counties within the Denver metro region: Denver County, Broomfield County, Northern Jefferson County, Western Adams County, and Southern Boulder County A home office located within 20 miles of the Colorado Department of Human Services (CDHS) offices at 1575 Sherman Street, Denver, CO is preferred. Candidates are preferred to reside in the following counties within the Denver metro region: Denver County, Broomfield County, Northern Jefferson County, Western Adams County, and Souther Boulder County.

The ideal home location is north of Interstate 70 (I-70), east of the foothills corridor served by the major highways such as Interstate 25 (I-25) and Interstate 76 (I-76) within this metro zone, and no further east than Denver International Airport. These major transportation routes support the frequent travel requirement throughout the assigned counties. Must possess a valid, non-restricted Colorado Driver's License Home as Sole and Permanent Work Place - The employee's home address shall serve as their official and regular work location for employment purposes.

While a portion of work will be performed from the home office, the majority of duties are expected to occur within County Departments of Human Services or other assigned county facilities, as determined by business needs. This Compliance Investigator II position will primarily conduct reviews throughout the greater Denver Metro area, with occasional travel to rural counties and regions as needed. Employees must maintain a home office, including reliable internet access and, if required, a phone, to perform assigned duties effectively.

Former State employees who were disciplinarily terminated or resigned in lieu of termination must: Disclose that information on the application. Explain why the prior termination or resignation should not disqualify you from the current position. Provide your employee number from your prior State employment.

Absent extraordinary circumstances, prior disciplinary termination or resignation in lieu of termination and failure to provide this information will disqualify the applicant from future State employment with CDHS. CDHS Selection Process Explanation Employment history is calculated on a full-time basis (40/hrs per week). Part-time employment is calculated on a prorated basis to determine qualifications.

Be sure your application specifically addresses your qualifications, experience, work products, and accomplishments as they relate to the position and minimum requirements. Preferred Qualifications & Competencies: Relevant years of state service experience. Minimum Qualification Screening Process A Human Resources Analyst will review the work experience/job duties sections of the online job application to determine whether your experience meets the minimum qualifications for the position.

You must complete the official State of Colorado online application. Cover letters and resumes WILL NOT be reviewed during the minimum qualifications screening process. You must specifically document your work experience and qualifications.

Do not use "see resume" or "see attached." You must meet the minimum qualifications to continue in the selection process. Part-time work experience will be prorated. Comparative Analysis Process - Structured Application Review After minimum qualification screening, the comparative analysis process will involve a review and rating of all the information you submit

The comparative analysis step may also include your results from standardized testing. Your Work Experience/Job Duties Document your work experience/job duties to the extent to which you possess th...


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