Raising the bar for care. Lowering risk for clients.
Provider Management Analyst I
Location
United States
Posted
4 days ago
Salary
$14 - $20 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Provider Management Analyst I
CorVel Corporation
Role 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. - 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 Qualifications - Ability to work independently - Strong organization skills - 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 Requirements - High School Diploma or equivalent required - Demonstrated knowledge of office experience 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 Description 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!).
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EPIC Radiant Application Analyst III
UTHealth (University of Texas Health Science Center at Houston)UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care.
Role Description UTHealth Houston is seeking an Epic Analyst to work with the Radiant module, which supports radiology practices. This position will be responsible for the ongoing design, build, testing, validation, and support of any Radiant modules used across the healthcare system. This analyst works with operational stakeholders and IT technical staff to troubleshoot Epic system issues and problems, capture requirements for new initiatives, and support project planning and execution. Works with end users to communicate improvements needed for business processes and contributes directly to the success of the UTHealth mission across technological, clinical, administrative, and financial perspectives. This is a remote role, but we give preference to candidates who live in Texas or are willing to move here. Qualifications - Certification or accreditation in the Epic Radiant module is required. - Bachelor's Degree in Computer Science, Business, or a related discipline required. May substitute required education with equivalent years of experience beyond the minimum experience requirement. - EPIC Certification by EPIC required. Requirements - At least 5 years of experience in a health care-related field required. - 3 years of experience supporting one or more Epic modules preferred. - Large-scale health care systems planning and implementation experience on application software products preferred. - Must receive a passing score (as defined by Epic), within two attempts, on all required exams and projects (as defined by Epic) within 6 weeks after completion of training or within a pre-determined 6 week timeframe. Benefits - 100% paid medical premiums for our full-time employees. - Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year). - The longer you stay, the more vacation you’ll accrue! - Longevity Pay (Monthly payments after two years of service). - Build your future with our awesome retirement/pension plan! - Free financial and legal counseling. - Free mental health counseling services. - Gym membership discounts and access to wellness programs. - Other employee discounts including entertainment, car rentals, cell phones, etc. - Resources for child and elder care. - Plus many more! Position Key Accountabilities - Maintains expertise and seeks additional knowledge in the support and optimization of the Radiant Epic module(s), and how they integrate with other applications. - Works cohesively with stakeholders to provide system support, including analysis, build, and testing of requested changes, and analysis of new functionality of applications. - Reviews, builds, tests, and implements new functionality via System Upgrades and Special Updates. - Works and manages multiple tasks independently. - Demonstrates timely, effective, and efficient troubleshooting of very complex production software and workflow issues (which may cross applications/teams) and defines mitigation plans for resolution. - Acts as primary contributor in the development and documentation of internal procedures to use in conjunction with Epic application support, maintenance, and optimization. - Helps develop build timelines and project plans. - Develops and maintains system documentation to enable ongoing support and maintenance of the Epic system. - Assists Application Director in developing build timelines and project plans as communicated by leadership. - Performs and oversees unit testing of application configurations and builds in appropriate non-production environments, to identify defects and create resolution plans accordingly. - Assists with the creation of test scripts and ensures test scripts for integrated and end-user testing are relevant and accurate. - Performs testing in a structured manner, follows any defined test scripts, and documents results. - Performs unit testing of application configurations and builds in appropriate non-production environments, identifies issues and potential solutions. - Follows established guidelines for system change control. - Creates and maintains documentation for change management, including cost estimation. - Project documentation, communication, and training plans. - Collaborates across teams to ensure process design, interface development, testing, and end-user training are performed to quality standards. - Independently performs basic project management activities for the development and implementation of system changes and medium to large projects. - Develops application-specific reports; provides technical specifications and assistance to report developers as needed. - Performs other duties as assigned. Certification/Skills - Superior communication skills, both oral and written, including specific skills of presentation and the effective communication of complex subjects to non-technical groups. - Superior customer relation skills including leading and participating in group sessions and reaching consensus. - Familiarity with project lifecycle and project management methodologies for software management. - Ability to plan and manage projects of various size; their tasks, dependencies, team members, other resources, and timeline. - The analytical skills to collect information from diverse sources, apply professional principles in performing various analyses, and summarize the information and data in order to solve problems or design relatively systems and programs that cross department/divisional lines. - Manages Human Resources activities of department in regards to: recruiting and selection, hiring and termination, training, professional development, mentoring, counseling, performance evaluations, and salary planning. Security Sensitive This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4. Residency Requirement We prefer employees who permanently reside and work in the State of Texas. Out-of-state applications will be considered, but must pass an exception process to complete.
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