This is a Fully Remote Job
About Our Client:
CERIS is a division of a corporation specializing in healthcare payments with a focus on clinical expertise and cost containment solutions. The organization addresses challenges in healthcare payment accuracy and transparency. It operates with a stable and growing presence, emphasizing core values such as accountability, commitment, excellence, integrity, and teamwork.
About the Opportunity:
The PROVIDER MANAGEMENT ANALYST III plays a critical role in verifying provider and patient information and managing documentation requests to support claims auditing. This position ensures the accuracy of information for proper request delivery, contributing to the integrity and efficiency of the claims auditing process.
Responsibilities:
Verify provider, patient, and client information for accuracy
Audit claims with documentation such as itemized bills, medical records, UB04’s, HCFA’s
Communicate issues to leadership as identified
Maintain production standards and quality of work
Assist team members and report potential issues proactively
Forward misdirected requests promptly
Maintain strict confidentiality of medical records, PHI, and PII
Make outbound calls as needed
Perform additional duties as assigned
Requirements:
High School Diploma or equivalent
Demonstrated office experience
Ability to work independently
Strong organizational, analytical, and problem-solving skills
Excellent attention to detail
Proficiency with MS Office (Word, Excel, Outlook) and Windows OS
Experience with outbound calling
Pay Range and Compensation Package:
Pay range: $18.34 - $27.40 per hour
Compensation determined based on location, skills, experience, qualifications, and other relevant factors
Benefits & Perks:
Medical insurance (HDHP) with pharmacy
Dental insurance
Vision insurance
Long Term Disability insurance
Health Savings Account options
Flexible Spending Account options
Life Insurance
Accident Insurance
Critical Illness Insurance
Pre-paid Legal Insurance
Parking and Transit FSA accounts
401(k) and ROTH 401(k)
Paid time off
Equal Opportunity Statement:
Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.