Note: The job is a remote job and is open to candidates in USA. CERIS, a division of CorVel Corporation, is dedicated to accuracy and transparency in healthcare payments. They are seeking a Repricing Quality Assurance Analyst I to review and analyze repricing audit data, ensuring compliance and operational effectiveness while collaborating with internal teams to enhance client satisfaction.
Responsibilities
- Identify and resolve quality issues within repricing processes
- Develop and implement QA policies and procedures
- Monitor compliance with pricing guidelines and contractual requirements
- Investigate repricing discrepancies and apply corrective actions
- Prepare QA reports and documentation
- Collaborate with stakeholders to align quality objectives
- Provide training and guidance on repricing standards
- Conduct risk assessments to mitigate potential errors
- Maintain confidentiality of client data, PHI, and PII
- Additional duties as assigned
Skills
- 5+ years in medical/insurance repricing, claims processing, or auditing
- 3+ years in quality assurance or equivalent combination of education and experience
- High School Diploma or higher required
- Repricing or network contracting experience preferred
- Associate's or Bachelor's degree preferred
Benefits
- 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 Overview
CERiS is a company that detects and resolves payment issues for health claims. It was founded in 1990, and is headquartered in Fort Worth, Texas, USA, with a workforce of 501-1000 employees. Its website is https://www.ceris.com/.Company H1B Sponsorship
CERIS has a track record of offering H1B sponsorships, with 2 in 2023, 5 in 2022, 2 in 2021, 1 in 2020. Please note that this does not guarantee sponsorship for this specific role.