Payment Integrity Analyst II

The Payment Integrity Analyst II is responsible for accurately reviewing and completing pre- and post-pay claim audits based on client, policy, industry standards and/or CMS guidelines.

Requirements

• 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
• Timely completion of internal audits and/or appeals
• Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings

Benefits

• Medical (HDHP) w/Pharmacy
• Dental
• Vision
• Long Term Disability
• Health Savings Account
• Flexible Spending Account Options
• Life Insurance
• Accident Insurance
• Critical Illness Insurance
• Pre-paid Legal Insurance
• Parking and Transit FSA accounts
• 401K
• ROTH 401K
• paid time off