9 bill review analyst ii jobs found in Fort Worth

Responsible for receiving and entering medical claims while maintaining accuracy and meeting turnaround requirements. The Setup Analyst provides a higher level skillset, supporting the goals of the Setup department, personal growth, and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Ensure bill is eligible for MCS review Handle / organize bills to be entered in a timely fashion Enter bill proficiently and accurately into internal system Communicate any special handling of each claim Maintains production standards and production requirements Comply with standard protocol for processing problem claims Responsible for high profile clients, including production, QC, communications, etc. Train new employees Function as back-up for filter or filter leads Requires punctual and consistent attendance Must be willing and able to work overtime as required Assist co-workers, supervisor and management in accomplishing...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   ESSENTIAL FUNCTIONS & 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 Use 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, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and analytical skills for...

The Procurement Coordinator is responsible for maintaining a consistent workflow by distributing claims to Procurement analysts. Keep track of current volume on an individual basis to ensure even distribution throughout department. QC/Review all outgoing files for quality and completeness. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: File distribution to all Procurement staff (initial distribution and redistribution as necessary) QC/Review incoming files before distribution to end users QC/Review outgoing files for completeness/accuracy for all end users work before moving file on to process Generate and/or send (mail/electronically) letters, reports, and forms as required to interoffice personnel as required. May from time to time, send reports to clients, managers, other CorVel offices Document procedures and all client specific protocols Requires regular and consistent attendance, complying with the company Employee...

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 remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES:  Ensures timely and accurate communication of information, in written and electronic forms, that are directed to internal company contacts, clients and providers Directs a designated group of employees in their day-to-day operations Monitors employee and unit quality control Ensures daily compliance with metrics Tracking and reporting of department metrics to Director of Operations on a monthly basis or as required Handles scheduling and monitoring of staff’s attendance Ensures timely distribution of...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position.  ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collect supporting data and analyze information to make decisions regarding accuracy of billing Appropriately document work and final conclusions in designated computer program Understanding of Surgical Implants Understanding of CERiS systems and Data Base informatics Capability to meet department expectations and standards Be a team player working with Leadership Team(s) within a positive team environment Additional duties/responsibilities as assigned Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as maintain HIPAA compliance   KNOWLEDGE & SKILLS: Exceptional organizational, strategic and critical...

Why GM Financial?   GM Financial is the wholly owned captive finance subsidiary of General Motors and is headquartered in Fort Worth, U.S. We are a global provider of auto finance solutions, with operations in North America, South America, and the Asia Pacific region. Through our long-standing relationships with auto dealers, we offer attractive retail financing and lease programs to meet the needs of each customer. We also offer commercial lending products to dealers to help them finance and grow their businesses.   At GM Financial, our team members define and shape our culture — an environment that welcomes new ideas, fosters integrity, and creates a sense of community and belonging. Here we do more than work — we thrive.   Our Purpose:  We pioneer the innovations that move and connect people to what matters   This position will be posted until filled. The Accountant II prepares journal entries, difficult and involved reconciliations, researches and resolves...

The Appeals Team Lead assists injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling a consistent, timely delivery of our quality services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receive incoming calls, emails and faxes from the Medical Access Assistant line Communicate clearly and professionally with providers and other stakeholders via phone and email Provide excellent customer service...

The IT Compliance Analyst supports the organization’s compliance and risk management programs by coordinating assessments, audits, and certifications across frameworks such as HITRUST, SOC, HIPAA, and NIST. This role helps maintain a strong IT compliance posture by managing evidence, monitoring control performance, maintaining documentation, and partnering closely with IT, Security, Privacy, Legal and external auditors. The Analyst also contributes to continuous improvement efforts, compliance automation initiatives, and reporting that supports leadership visibility and informed decision-making.   Key Responsibilities Assessment & Audit Support Coordinate internal and external compliance assessments, audits and certifications. Prepare, organize, and manage evidence to meet control and audit requirements. Track remediation activities and ensure timely closure of identified gaps. Maintain audit-ready documentation and support readiness reviews. Additional...

The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.  Clinical and/or technical expertise is utilized to address the provision of medical care and to identify inappropriate billing practices and errors inclusive of, but not limited to; duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with  diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and...