62 bill review analyst i jobs found

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 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...

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 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...

JOB SUMMARY: The Payment Integrity Analyst (Team Lead) assists with leading the Policy and Payment Integrity (PPI) team while maintaining the regular duties and responsibilities of this role which is accurately reviewing pre and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   The Team Lead must also be knowledgeable of the application of client policy and industry standards within reviews conducted by CERIS including but not limited to itemized bill review, professional review, hospital outpatient; trend analysis of internal auditing, appeals of pre and post payment claims, and any other claim or record that requires quality review to determine claim accuracy; assist with development of internal quality assurance measures based on client policy and industry guidelines; perform quality assurance reviews; assist in researching and implementing best practices related to payment policy, and/or policy initiatives; researching...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity The candidate selected will provide technical consultation and guidance to the business for the interpretation and assessment of information security risk for projects, technologies, and environments. They will integrate risk management strategies and educate risk owners across the enterprise on information security requirements and best practices. The candidate will evaluate, administer, and implement systems, policies and processes which serve to enhance the mitigation, reporting, and analysis of Information...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Business Support Analyst Lead supporting the Property & Casualty Portfolio Management Office, you will be instrumental in ensuring the health and success of the P&C Portfolio and its shared functions by expertly identifying, analyzing, and visualizing intricate business data. Your ability to generate profound insights will directly enable strategic decision-making and drive significant business outcomes. This role entails exceptional stakeholder management, effective communication, a...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Plano, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, Chesapeake, VA or Tampa, FL. Relocation assistance is not available for this position. The Senior Graph Data Scientist – Identity Analytics is responsible for development and implementation of quantitative solutions that improve USAA’s ability to detect and prevent...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We offer a flexible work environment that requires an individual to be in the office 4 days per week. This position can be based in one of the following locations: San Antonio, TX, Plano, TX, Phoenix, AZ, Colorado Springs, CO, Charlotte, NC, or Tampa, FL. Relocation assistance is not available for this position. The Lead Graph Data Scientist - Identity Analytics is responsible for development and implementation of quantitative solutions that improve USAA’s ability to detect and prevent identity theft,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We are seeking an experienced and strategic Director, Product Owner to lead our team of Development Product Owners and Scrum Masters. This pivotal role will be instrumental in shaping the future of our member data product capabilities, such as member or customer 360 initiatives, ensuring they align with our business objectives and deliver outstanding value to USAA. You will be responsible for the end-to-end strategy, cost, and risk management of our member data products. Provides direction and oversight to a...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity The Opportunity: Reputation and Enablement Team is seeking an experienced Business Support Analyst – Mid-Level, to join our team and provide data analytics services to the Corporate Communications and Public Affairs Office. The incumbent will assist business operations by collecting moderately complex data from trusted sources, using statistical techniques to analyze the data for trends, as well as generating reports and data visualizations that leaders will use to make informed decisions. Conduct data analytics...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As business process owner, plans, directs, and coordinates activities for complex processes, including problem definition, evaluation of requirements, design, testing, and implementation of business processes. Understands the process operating objectives, business rules, performance requirements, risks, and controls and interactions between dependent processes to minimize failures, eliminate redundancies, and control process performance necessary to achieve efficient, effective design and execution of the process....

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As business process owner, leads planning for highly complex processes including problem definition, evaluation of requirements, design, testing, and implementation of business processes. Understands the process operating objectives, business rules, performance requirements, risks, and controls and interactions between dependent processes to minimize failures, eliminate redundancies, and control process performance necessary to achieve efficient, effective design and execution of the process Actively develops and...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a trusted advisor and strategic partner to senior executive leadership as an HR Business Partner Manager , you will drive business value through development of long-term talent strategies aligned with business objectives. Leveraging business acumen, data-driven insights and innovative thinking to solve complex HR and business challenges, you will influence key decisions impacting organizational performance while driving initiatives that result in a high-performing and engaged workforce. This is an individual...

The Data Verification Specialist is responsible for all bill review clerical functions, including mail, prepping and scanning medical bills, data entry, data verification and assisting with various phone and email tasks to support the bill review department. This is a remote position however, residing in TX-DFW area is preferred but not required. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Validate incoming data to the Bill Review system Identify and apply customer-specific rules and processes Requires continual and consistent communication with supervisor regarding status of Data Verification queues and workload Assist the bill review department with all clerical duties as assigned Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to work on several concurrent tasks and prioritize workload with minimal direction Ability to identify, analyze and solve problems Basic computer proficiency, including familiarity with Microsoft Office...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a trusted advisor and strategic partner to senior executive leadership as an HR Business Partner Director , you will drive business value through development of long-term talent strategies aligned with business objectives. Leveraging business acumen, data-driven insights and innovative thinking to solve complex HR and business challenges, you will influence key decisions impacting organizational performance while driving initiatives that result in a high-performing and engaged workforce. This is an individual...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As business process owner, plans, directs, and coordinates activities for complex processes, including problem definition, evaluation of requirements, design, testing, and implementation of business processes. Understands the process operating objectives, business rules, performance requirements, risks, and controls and interactions between dependent processes to minimize failures, eliminate redundancies, and control process performance necessary to achieve efficient, effective design and execution of the process....

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity USAA is enhancing its digital experience to better serve our members' evolving needs. To support this, our marketing analytics team is expanding its focus to encompass the with a focus on paid media optimization to drive maximum efficiency & growth. We're seeking a Paid Media Decision Science Analyst to be a foundational member of our marketing team, playing a key role in shaping data-driven improvements across our digital sales experience. In this role, you'll leverage your advanced marketing analytics...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity The Opportunity: USAA is seeking an Executive Director, P&C Data & Analytics Delivery who will be accountable for the strategy, design, delivery, maintenance, and support of all data and analytics capabilities and technical solutions for USAA’s P&C insurance business, with a specific focus on Distribution, Sales, Agency, SBI, Innovation & Transformation priorities. This pivotal role demands close partnership with senior IT and Business executives within P&C and across the Association to drive...

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...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity Join our Member Value team as a  Lead Business Strategy Analyst .  This role is instrumental in shaping the future of our member service experiences by bridging in-depth analytics with strategic foresight. You will analyze current trends, identify emerging opportunities, and develop robust plans to drive higher member satisfaction and value.  You will collaborate closely with business leaders to translate strategic vision into actionable plans. This is a unique opportunity to apply your analytical and...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity This role is for an Audit Data Analyst II - Staff Auditor (Intermediate) responsible for performing audit data analytics in collaboration with audit teams. The position involves driving innovation in audit execution by finding opportunities for data analytics and by developing, deploying, and supporting data analysis solutions. Candidates are expected to have two or more years of experience in data analytics, with an understanding and experience in Tableau, Python, and/or Snowflake. Previous audit experience is...