The Customer Service Representative is responsible for addressing client and / or provider inquiries via email, fax, telephonic, or written correspondence ensuring adherence to contractual and state guidelines as well as client instructions. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES. Answer phone calls, return phone calls. Answer emails from clients, providers and internal referring offices. Review previous history of the ...
The Payment Integrity Analyst is responsible for accurately reviewing pre and post pay claim audits based on client, policy, industry standards and / or CMS guidelines. This is a remote position. ESSENTIAL FUNCTIONS AND 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 j...
The CERIS Operations Manager is responsible for overseeing all aspects of the department including Personnel Hiring, Quality Assurance of Product, Workflow, Maintaining the tracking of and accountability of staff regarding production standards and department expectations. Works collaboratively with other department managers to achieve departmental requirements and goals.This is a hybrid position.ESSENTIAL FUNCTIONS AND RESPONSIBILITIES : Ensure t...
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. This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES. Communic...
The Revenue Mapping Analyst is responsible for the conversion of Enhanced Bill Review results into a UB formatted document that is indicative of the results by Revenue Code lines. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES. Conversion of the Summary of Adjusted Report results into a UB formatted document. Applies QC protocols to ensure accuracy of conversion. Applies individual line results by UB Revenue Code. Ensures speci...
The Implementation Manager will be responsible for enhancement to existing products and development of new products to broaden current service offerings. This role will also be accountable for project management and implementation management with new and existing clients. The primary purpose of the role is to work closely with the assigned Account Manager, Implementation Coordinators, IT, and Operations to complete the implementation of client pr...
