CERiS Jobs in United States

The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. · ...

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 Senior Director of Product Development & Management is responsible for leading the strategy, execution, and lifecycle management of cross-functional products in medical cost containment. · This role ensures alignment with CERIS' annual strategic objectives while addressing ev ...

The Account Executive is responsible for interacting with customers and prospects on an executive level and acting as an extension of the client; selling new services. · ...

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. · This is a remote position. Communicate with respective leadership o ...

The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine correct DRG/coding and clinically supported as defined by review methodologies specific to t ...

The Document Processing Department Manager is responsible for overseeing all aspects of the department including Personnel Hiring and Quality Assurance of Product. · Associates degree national certification or equivalent · Minimum 5 years office experience · Previous Supervisory ...

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. · Collects supporting data and analyzes information to make decisions regarding accuracy of billingApp ...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims. · This is a remote position. · ...

The Procurement Team Lead position is 50% production and 50% assisting and supporting direct supervisor with ensuring the team meets protocol, as well as performing supervisory duties during the supervisor's absence. · This job requires onsite presence. ...

The Account Manager is responsible for interacting with customers on an executive level and acting as an extension of the client; understanding and communicating agreed upon expectations to field offices and increasing the market share of business by providing service that meets ...

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 role is r ...

The CERIS Operations Supervisor role requires a supervisor to oversee daily production for the department, managing functions such as human resources and customer service. · Key Responsibilities: · Approve Electronic time cards for employees · Assist Manager in establishing emplo ...

This position is responsible for monitoring and tracking processes and training new employees. · High school diploma or equivalent. · Experience in Excel with filtering formulas & Pivot Tables. · ...

+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. · +Collects supporting data and analyzes information to make decisions regarding accuracy of billing ...

The Appeals (Provider Relations) Supervisor is responsible for daily operations within the Provider Relations department.The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests al ...

The Closing Analyst is responsible for closing client files and applying results into Scheck and CareMC systems to meet daily production expectation and standards. · This is a remote role. Ensure all appropriate documentation is attached and follow departmental QC protocolsComple ...

The Correspondence Department 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 expectatio ...

The PPI Coordinator plays a key role in supporting the Policy and Payment Integrity teams by managing workflow, ensuring timely assignment of appeals, and maintaining accurate tracking systems.This position requires strong organizational skills, attention to detail, and the abili ...

The Appeals Team Lead will be responsible for providing expertise in reviewing appeals and grievances. Corresponds with parties regarding appeal issues. · Answer team questions as neededMonitor and work QC queueDistribute appealsCreate response to address issues raised by an empl ...