CorVel Corporation · 9 hours ago
Payment Integrity Analyst II
Fort Worth, TX
Full-time
Remote
Entry Level
$64K/yr - $97K/yr
1+ years exp
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Responsibilities
Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication.
Ability to use clinical judgement and analytical skills to appropriately review documentation submitted for claim audits.
Utilize clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits.
Utilize applicable tools and resources to complete internal audits and/or appeals.
Timely completion of internal audits and/or appeals.
Attends Clinical Team Meetings, All Company Meetings, Education Opportunities, Trainings, and other potential meetings.
Additional duties as assigned.
Qualification
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Required
Must maintain a current LPN, LVN and/or RN licensure
Strong understanding of claims processing, ICD-10 Coding, DRG Validation, Coordination of Benefits
Strong understanding of healthcare revenue cycle and claims reimbursement
Proficient in Microsoft Office including Pivot Tables and Database Management
Demonstrate ability to manage multiple projects, set priorities and adhere to committed schedule
Strong interpersonal skills and adaptive communication style, complex problem solving skills, drive for results, innovative
Excellent written and verbal communication skills
Proven track record of delivering concrete results in strategic projects/programs
Strong analytical and modeling ability and distilling data into actionable results
Superb attention to detail and ability to deliver results in a fast paced and dynamic environment
1+ years healthcare revenue cycle
1+ years of relevant experience or equivalent combination of education and work experience
1+ years hospital bill audit
Preferred
Preferred experience with health insurance denials and/or appeals, payer audits, or vendor audits
Bachelor’s degree in healthcare or related field preferred
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
CorVel Corporation
CorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry.
1001-5000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown1991-07-05IPO
Leadership Team
Michael Combs
President and CEO
B
Brandon O'Brien
Chief Financial Officer
Recent News
MarketScreener
2024-11-29
2024-04-06
Company data provided by crunchbase
