Repricing Quality Assurance AnalystThe Repricing Quality Assurance Analyst is responsible for reviewing, analyzing, and monitoring repricing audit data across multiple platforms to ensure accuracy, compliance, and efficiency. Works closely with internal teams to maintain contractual and organizational standards, enhance operational effectiveness, and improve client satisfaction. This is a remote position.Essential Functions & Responsibilities:Identify and resolve quality issues within repricing processesDevelop and implement QA policies and proceduresMonitor compliance with pricing guidelines and contractual requirementsInvestigate repricing discrepancies and apply corrective actionsPrepare QA reports and documentationCollaborate with stakeholders to align quality objectivesProvide training and guidance on repricing standardsConduct risk assessments to mitigate potential errorsMaintain confidentiality of client data, PHI, and PIIAdditional duties as assignedKnowledge & Skills:Strong understanding of repricing claims processing, and contractual rate applicationKnowledge of healthcare revenue cycle and reimbursementKnowledge of applicable regulations and pricing guidelinesProficiency in Microsoft Office and multi-platform systemsExcellent analytical, problem-solving, and communication skillsHigh attention to detail with the ability to work in fast-paced environmentsAbility to work independently and within a team environmentEducation & Experience:5+ years in medical/insurance repricing, claims processing, or auditing3+ years in quality assurance or equivalent combination of education and experienceRepricing or network contracting experience preferredHigh School Diploma or higher required; Associate's or Bachelor's degree preferredPay Range: $19.21 - $28.73 per hourAbout CERiS:CERiS, a division of CorVel Corporation, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).A comprehensive benefits package is available for full-time regular employees and includes 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, and paid time off.CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
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