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!).
Provider Management Analyst I
Location
United States
Posted
10 days ago
Salary
$14 - $20 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Provider Management Analyst I
CERIS
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!).
Related Guides
Related Categories
Related Job Pages
More Analyst Jobs
• Dive into the cutting-edge of technology, meticulously analyzing various content infringements. • Collaborate with experts in diverse fields such as Hate Speech, Misinformation, Intellectual Property, and Copyright. • Write adversarial prompts to identify weaknesses in various AI models, including LLMs, Text-to-Image, Text-to-Video, AI Agents. • Oversee data management to guarantee the highest quality of outputs. • Develop adversarial and risky prompt strategies across several areas of abuse to expose potential vulnerabilities in models. • Manage projects end-to-end, from initial planning and oversight through quality assurance to final delivery. • Handle extensive datasets across multiple languages and areas of abuse, ensuring precision and meticulous attention to detail. • Ongoing investigation into new tactics for circumventing foundational models' safety measures. • Work alongside diverse teams to tackle new challenges and craft forward-thinking strategies and resolutions. • Promote a culture of knowledge exchange and continual learning within the team.
• Design, build and evolve conversational flows on the Grace platform. • Develop journeys focused on a simple, intuitive and efficient user experience. • Map business rules and specify integrations with system APIs such as ERPs, CRMs and partner platforms. • Plan, configure, launch and monitor communication campaigns via WhatsApp. • Work closely with Product, Development, Implementation, Customer Success and Sales teams. • Propose new features, automations and experiences using Artificial Intelligence. • Participate in the validation of new features and ensure the quality of deliverables. • Translate customer needs into scalable conversational solutions. • Document functional requirements, flows and business rules.
• Revisão de apurações de impostos: PIS e COFINS sob faturamento, impostos Retido (ISS, IRRF, CSRF e INSS), ICMS próprio, ICMS-ST e ICMS-DIFAL como outros. • Revisão de obrigações acessórias: EFD-CONTRIBUIÇÕES, EFD-ICMS/IPI, REINF, entre outras • Responsável pela parametrização fiscal e configuração sistêmica no sistema SAPB1, assim como nas adaptações da reforma tributária • Responsável pelo acompanhamento dos processos fiscal de integração e automação no sistema do SAPB1 e outros • Responsável pela gestão , monitoramento e direcionamento da regularidade fiscal (Federal, Municipal e Estadual) e regularidade cadastral dos clientes de acordo com os sistemas internos. • Responsável pelo acompanhamento dos processos de faturamento e suporte ao time fiscal interno • Responsável pela implantação de novos clientes • Atendimento ao cliente e atendimento interno ao time • Acompanhamento de situação fiscal dos estados municípios e receita federal do Brasil (RFB), assim como monitoramento de CND (Certidão Negativa de Débito) e monitoramento de vencimento de certificado digital
Role Description We're searching for an HRIS Cloud Analyst - Intermediate to join our UPMC team! This full-time position offers fully remote work arrangements. In this role, the HRIS Cloud Analyst - Intermediate provides innovative thinking and experienced problem-solving techniques to support the UPMC Human Resources team. This role supports the development and maintenance of Oracle HCM Cloud and other related HR systems, ensuring relevance, integrity, and reliability. Daily job responsibilities may involve: - Project work - Talent management support - Learning support - Security administration Our ideal candidate has experience with Oracle Recruiting Cloud (ORC). Additionally, they are a highly organized professional who communicates effectively, manages multiple priorities with ease, and thrives in a fast-paced environment. If this sounds like you, apply online today for your chance to join our team! Qualifications - Bachelor's degree in Information systems or similar program and two years of experience with modern technology and application support through education or practical experience required. - OR High School Diploma/GED and four years of experience with modern technology and application support through education or practical experience required. Requirements - Provides production support by monitoring departmental email requests. - Researches and resolves HR system problems, unexpected results, or process flaws. - Escalates and communicates issues through appropriate channels. - Leads system improvements and maintenance. - Coordinates efforts across internal and external teams. - Completes configuration and build of the HR systems. - Ensures thorough execution and documentation of key activities (including design, testing, cutover). - Supports change management, ensuring end users are well prepared. - Engages with key business stakeholders to identify opportunities for business process improvement through requirements gathering and exploration of pain points. - Develops system and procedural expertise in one or more HR related subject areas. - Reviews HR system release notes to identify opportunities and impacts. - Recommends solutions or alternate methods for improvement that align with business needs and strategic goals. - Ensures compliance with all regulatory requirements. Preferred Skillset - Strong end-to-end configuration and support experience of Oracle Recruiting Cloud (ORC). - Experience with monitoring and analyzing Oracle’s quarterly release notes (e.g., 26A, 26B) to identify new features, bug fixes, and mandatory changes affecting ORC. - Lead the impact assessment and regression testing for each release to ensure global configurations and integrations remain stable. - Strong technical expertise in Oracle HCM integrations, data extracts (SQL, HCM Extracts, BI Publisher). - Strong technical expertise in Oracle components such as HDL, value sets, fast formulas, eligibility rules, journeys, and other tools. - Functional knowledge of broader Oracle HCM modules (Core HR, Talent Management) and the overall HR technology ecosystem. - Experience with Oracle ATS products Taleo and Transitions. - Experience with Symphony Telemetry. - Experience with Oracle Verified Integrations (OVI) with third-party vendors for background checks, assessments, and other recruiting services. Licensure/Clearances - Act 34


