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Role Description

The CERIS Certified Coder reverse codes previously coded medical bills to determine coding accuracy. This role is responsible for making claim-related recommendations and communicating status of the claim to involved stakeholders. This is a remote position.

Essential Functions & Responsibilities

• Receives claim and processes based on state rules and regulations
• Determines validity and compensability of the claim using CorVel proprietary programs
• Makes recommendations and communicates claim status to referring office
• Read and comprehend all medical reports
• Adhere to client and carrier guidelines and participate in claims review as needed
• Assists other claims professionals with more complex or problematic claims as necessary
• Maintain HIPAA compliance
• Additional duties as assigned

Qualifications

• High School diploma or equivalent
• Current AAPC certification (which must be maintained throughout employment as current and active status)
• Certification as CPC with the AAPC for more than 2 years (w/ surgical or office experience)
• Current or recent orthopedic billing/coding experience
• EncoderPro software experience
• E/M coding/down-coding experience
• Texas workers' compensation experience is preferred
• Pain Management/Anesthesia/General Surgery coding experience is preferred

Requirements

• Ability to learn rapidly to develop knowledge and understanding of claims practices
• Strong organizational skills
• Ability to meet or exceed performance competencies
• Effective and professional verbal and written communication skills
• Ability to handle demanding situations while using critical and strategic thinking skills
• Demonstrated outstanding leadership, problem solving, and analytical skills
• Ability to think and work independently, while working in an overall team environment
• Proficient in Microsoft Office, especially Excel and Outlook

Benefits

• Comprehensive benefits package for full-time regular employees
• 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

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: $51,738 – $77,363

Company Description

CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, 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!).