[Remote] CERIS Repricing Quality Assurance Analyst I

Note: The job is a remote job and is open to candidates in USA. CorVel Corporation is a certified Great Place to Work® Company that offers healthcare payment solutions. They are seeking a Repricing Quality Assurance Analyst I who will be responsible for reviewing and monitoring repricing audit data to ensure compliance and efficiency while collaborating with internal teams to enhance operational effectiveness.ResponsibilitiesIdentify and resolve quality issues within repricing processesDevelop and implement QA policies and proceduresMonitor compliance with pricing guidelines and contractual requirementsInvestigate repricing discrepancies and apply corrective actionsPrepare QA reports and documentationCollaborate with stakeholders to align quality objectivesProvide training and guidance on repricing standardsConduct risk assessments to mitigate potential errorsMaintain confidentiality of client data, PHI, and PIIAdditional duties as assignedSkillsIdentify and resolve quality issues within repricing processesDevelop and implement QA policies and proceduresMonitor compliance with pricing guidelines and contractual requirementsInvestigate repricing discrepancies and apply corrective actionsPrepare QA reports and documentationCollaborate with stakeholders to align quality objectivesProvide training and guidance on repricing standardsConduct risk assessments to mitigate potential errorsMaintain confidentiality of client data, PHI, and PIIStrong understanding of repricing claims processing, and contractual rate applicationKnowledge of healthcare revenue cycle and reimbursementKnowledge of applicable regulations and pricing guidelinesProficiency in Microsoft Office and multi-platform systemsExcellent analytical, problem-solving, and communication skillsHigh attention to detail with the ability to work in fast-paced environmentsAbility to work independently and within a team environment5+ years in medical/insurance repricing, claims processing, or auditing3+ years in quality assurance or equivalent combination of education and experienceHigh School Diploma or higher requiredRepricing or network contracting experience preferredAssociate's or Bachelor's degree preferredBenefitsMedical (HDHP) w/PharmacyDentalVisionLong Term DisabilityHealth Savings AccountFlexible Spending Account OptionsLife InsuranceAccident InsuranceCritical Illness InsurancePre-paid Legal InsuranceParking and Transit FSA accounts401KROTH 401KPaid time offCompany OverviewCorVel is a nationally recognized claims management and managed care provider with over 30 years of experience in the industry. It was founded in 1987, and is headquartered in Irvine, California, USA, with a workforce of 1001-5000 employees. Its website is https://www.corvel.com/.Company H1B SponsorshipCorVel Corporation has a track record of offering H1B sponsorships, with 2 in 2023, 5 in 2022, 2 in 2021, 1 in 2020. Please note that this does not guarantee sponsorship for this specific role.