Senior Manager Clinical Audit

ESSENTIAL FUNCTIONS & RESPONSIBILITIES

• Utilize education, experience, and industry best practices to lead teams of auditors to plan, execute and deliver timely and accurate results
• Professional and timely communication with clients, account management and other departments
• Build, lead, and manage remote and/or onsite teams made up of managers, supervisors, and staff through hiring, onboarding, ongoing career development, and a positive team environment
• Work directly with managers and supervisors to implement performance metrics and evaluation systems to assess individual and team performance
• Responsible for all HR related duties for direct and indirect staff
• Responsible for managing and maintaining all KPIs and adherence to SLAs, identifying and resolving problems, preparing, and completing action plans to drive process improvement
• Responsible for tracking and reporting departmental metrics to director or executive leadership as requested
• Responsible for monitoring and compliance with turnaround times and other SLAs as required by our clients
• Responsible for daily, weekly, monthly reviews of various reports, invoices, logs, and expenses
• Acts as a point of contact for both internal and external customers
• Maintain HIPAA/patient confidentiality
• Additional duties as assigned

CROSS-FUNCTIONAL LEADERSHIP

KNOWLEDGE & SKILLS

• Knowledge of hospital billing requirements including UB-04, HCFA1500, itemized bills, revenue codes, CPT/HCPCS codes, ICD10 diagnosis and procedure codes
• Knowledge of industry standards for medical bill audit based on national and state policy guidelines including how to research those policies and guidelines
• Ability to write and speak clearly, easily communicating complex ideas
• Ability to interpret and answer complex questions and requests
• Ability to think critically and work independently to meet deadlines and complete priorities
• Ability to remain composed in stressful situations and communicate professionally
• Must be proficient in Microsoft Office applications including Excel
• Must have exceptional organizational skills

EDUCATION & EXPERIENCE

PAY RANGE

• CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
• For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
• Pay Range: $92,673 – $143,587
• A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
• In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

ABOUT CERIS

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

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