Provider Management Analyst II

CERIS; Fort Worth (TX); Remote; USD 52,000 - 75,000; Full time

Job summary

CERIS, a division of CorVel Corporation, is seeking a Provider Management Analyst to verify provider information and audit requests for documentation such as itemized bills and medical records. This is a remote role designed to support healthcare payments accuracy and confidentiality.

You will communicate with leadership, maintain quality standards, and assist teams while handling confidential PHI/PII with diligence and timely delivery.

Qualifications

• High School Diploma or equivalent.
• Demonstrated knowledge of office experience.
• Ability to work independently.
• Strong analytical and problem-solving skills.
• Excellent attention to detail.
• MS Office proficiency (Word, Excel, Outlook).

Responsibilities

• Communicate with leadership on issues identified.
• Maintain production standards, requirements, and quality of work.
• Assist coworkers, supervisor, or management to accomplish goals; report potential issues.
• 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.

Skills

Independent work

Analytical skills

Attention to detail

Timeliness

Outbound calls

Education

High School Diploma

Tools

MS Word

MS Excel

MS Outlook

Job 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 position.

ESSENTIAL FUNCTIONS & 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
• Additional duties as assigned

KNOWLEDGE & SKILLS:

• Ability to work independently
• 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

EDUCATION & EXPERIENCE:

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

PAY RANGE:

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

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!).

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.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.