CERIS operates as a CorVel subsidiary serving health plans, state Medicaid agencies, and managed care organizations on claim payment accuracy and overpayment recovery. The tech stack is compliance-heavy (HITRUST, NIST, OneTrust, ServiceNow) and Microsoft-centric, reflecting a regulated, process-driven operation. Active hiring is concentrated in healthcare operations roles—16 of 41 open positions—alongside a small sales team, suggesting a direct-sales or managed-services model targeting state and commercial payers.
CERIS helps healthcare payers prevent improper claim payments and recover overpayments through pre- and post-payment integrity services. The company serves state agencies, commercial health plans, managed care organizations, and third-party administrators nationwide. Core service areas include itemization review, clinical review, implant cost review, high-cost drug review, and fraud/waste/abuse detection. Current project focus spans appeals and rebuttals, prepayment and postpayment solutions, compliance automation, and payment integrity process standardization—reflecting operational maturity and regulatory expansion.
CERIS uses Windows, Microsoft Office (Outlook, Excel, Word, PowerPoint), ServiceNow for IT service management, OneTrust for compliance, Salesforce for CRM, and HITRUST/NIST for healthcare security standards.
Current projects include appeals and rebuttals, prepayment and postpayment claim solutions, claims accuracy improvement, compliance automation and metrics dashboards, and payment integrity process standardization for state and commercial health plans.
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