Provider Management Analyst II

CorVel Career Site • Fort Worth, TX

1d • Remote

About The Position

The Provider Management Analyst is responsible for verifying provider information and requests for documentation used to audit claims, including itemized bills, medical records, UB04s, and HCFAs. The role verifies patient, provider contact, and client information for accuracy to ensure proper delivery of requests. This is a remote position.

The position requires maintaining production and quality standards, communicating issues to leadership, supporting coworkers and management in meeting product goals, and handling misdirected requests promptly. Outbound calling may be needed. The role requires strict confidentiality of medical records, protected health information (PHI), and personally identifiable information (PII).

CERIS, a division of CorVel Corporation, provides clinical expertise and cost-containment solutions focused on accuracy and transparency in healthcare payments. The company describes itself as stable and growing, with a supportive culture and career advancement opportunities, and emphasizes its values of Accountability, Commitment, Excellence, Integrity, and Teamwork.

Requirements

• High school diploma or equivalent.
• Demonstrated knowledge of office experience.
• Ability to work independently.
• Strong organizational skills.
• Strong analytical and problem-solving skills.
• Excellent attention to detail.
• Ability to deliver results in a timely manner.
• Knowledge of MS Office, including Word, Excel, and Outlook, and the Windows operating system.
• Outbound call experience.

Responsibilities

• Verify provider information and requests for documentation used to audit claims, including itemized bills, medical records, UB04s, and HCFAs.
• Verify patient, provider contact, and client information for accuracy to ensure proper delivery of requests.
• Communicate issues or problems identified to the appropriate leadership.
• Maintain production standards, production requirements, and quality of work.
• Assist coworkers, supervisors, and management in accomplishing product goals; proactively report potential issues.
• Forward misdirected requests to the correct recipient in a timely manner.
• Maintain strict confidentiality of medical records, PHI, and PII.
• Make outbound calls as needed.
• Perform additional duties as assigned.

Benefits

• Medical (HDHP) with pharmacy coverage
• Dental insurance
• Vision insurance
• Long-term disability insurance
• Health Savings Account
• Flexible Spending Account options
• Life insurance
• Accident insurance
• Critical illness insurance
• Pre-paid legal insurance
• Parking and Transit FSA accounts
• 401(k)
• ROTH 401(k)
• Paid time off

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED