Provider Management Analyst II

About Ceris

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!).

Responsibilities

• 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
• Verify provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc.
• Verify patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests
• Additional duties as assigned

Requirements

• 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
• Proficiency in MS Office including Word, Excel, and Outlook; Windows operating system
• Outbound call experience

Qualifications

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

Pay

CorVel uses a market-based approach to pay. Pay rates are established taking into account federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. The pay range for this role is $15.61 - $23.82 per hour.

Benefits

A comprehensive benefits package is available for full-time regular employees and includes:

• Medical (HDHP) with 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 and ROTH 401K
• Paid time off

For more details, visit CorVel Careers | Opportunities in Risk Management.