CorVel

Certified Medical Coder (Professional Review Specialist I) The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Essential Functions & Responsibilities: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned Knowledge & Skills: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office applications...

Ceris Certified Coder I Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program ("IIPP"), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...

Ceris Certified Coder I Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program ("IIPP"), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...

Ceris Certified Coder I Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program ("IIPP"), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...

Professional Review Specialist II (Certified Professional Medical Coder) The Professional Review Specialist provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills to determine appropriateness of medical care. This position will be in our Hartford, CT office during training, and once fully trained transitioned to a hybrid work arrangement. Essential Functions & Responsibilities: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned Knowledge & Skills: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical...

Ceris Certified Coder I Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program ("IIPP"), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...

Ceris Certified Coder I Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program ("IIPP"), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...