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Provider Management Analyst III

Provider Management Analyst III

CorVelRochester, NY, US
2 days ago
Job type
  • Full-time
Job description

Provider Management Analyst III

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 position.

Essential Functions and Responsibilities :

  • Communicates with respective leadership on any issues or problems identified
  • Punctual and consistent attendance required
  • Maintains production standards, production requirements, and quality of work
  • Assist coworkers, supervisor, or management to accomplish product goals and reports any potential issues in a proactive manner
  • Forwarding misdirected requests to the correct individual / department to respond to any requests timely
  • Outbound calling may be needed for specific roles
  • Ensure strict confidentiality of all medical records, PHI, and PII
  • Additional duties as assigned

Knowledge & Skills :

  • Ability to work independently and use critical thinking
  • Outbound call experience
  • Organized and ability to multitask
  • MS Office including Word, Excel and Outlook; Windows operating system and Internet
  • Strong analytical and problem-solving skills
  • Strong attention to detail and ability to deliver results in a timely manner

    • Education / Experience :

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

    • Pay Range : $17.93 - $26.79 per hour

    About CERIS :

    CERIS, a division of CorVel Corporation, 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!).

    A comprehensive benefits package is available for full-time regular employees and includes 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, and paid time off.

    CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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