Repricing Quality Assurance Analyst I

CERIS • Fort Worth, TX

1d • Remote

About The Position

The Repricing Quality Assurance Analyst is responsible for reviewing, analyzing, and monitoring repricing audit data across multiple platforms to ensure accuracy, compliance, and efficiency. Works closely with internal teams to maintain contractual and organizational standards, enhance operational effectiveness, and improve client satisfaction.

Requirements

• Strong understanding of repricing claims processing, and contractual rate application
• Knowledge of healthcare revenue cycle and reimbursement
• Knowledge of applicable regulations and pricing guidelines
• Proficiency in Microsoft Office and multi-platform systems
• Excellent analytical, problem-solving, and communication skills
• High attention to detail with the ability to work in fast-paced environments
• Ability to work independently and within a team environment
• 5+ years in medical/insurance repricing, claims processing, or auditing
• 3+ years in quality assurance or equivalent combination of education and experience

Nice To Haves

• Repricing or network contracting experience preferred

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

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

What This Job Offers

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