Provider Management Analyst II

Role Description

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests. This is a remote role.

• Communicate with respective leadership on any issues or problems identified
• Maintain production standards, production requirements, and quality of work
• Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner
• Timely forward misdirected requests to the correct recipient
• Ensure strict confidentiality of all medical records, PHI, and PII
• Outbound calling may be needed
• Additional duties as assigned

Qualifications

• Ability to work independently
• Strong organization skills
• Strong analytical and problem-solving skills
• Excellent attention to detail
• Ability to deliver results in a timely manner
• MS Office including Word, Excel, and Outlook; Windows operating system
• Outbound call experience

Requirements

• High School Diploma or equivalent required
• Demonstrated knowledge of office experience

Benefits

• Comprehensive benefits package for full-time regular employees
• 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

Company Description

CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).