CorVel

Certified Medical Coder I (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 role is available for remote, onsite and hybrid work arrangements. 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...

A healthcare solutions provider is seeking a CERIS Certified Coder to reverse code medical bills for accuracy. Key responsibilities include processing claims, determining their validity, and communicating with stakeholders. Essential qualifications include a High School diploma, AAPC certification, and experience in orthopedic billing. This position allows for remote work and offers a comprehensive benefits package, emphasizing growth and support for employees. #J-18808-Ljbffr

CERIS Certified Coder I 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 KNOWLEDGE & SKILLS: Ability to learn rapidly to develop knowledge and understanding of claims practices Strong organizational skills Ability to meet or...

CorVel Corporation is searching for a Certified Medical Coder I (Professional Review Specialist I) in the City of Syracuse, NY. This role involves analyzing medical services and billing to evaluate accuracy and medical necessity. The position is available for remote, onsite, and hybrid work arrangements. The ideal candidate should have an Associate’s degree or equivalent experience along with CPC or CPC-A certification. Strong knowledge of ICD codes and medical terminology is essential. A comprehensive benefits package is offered to full-time employees. #J-18808-Ljbffr

CERIS Certified Coder II 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 KNOWLEDGE & SKILLS: Ability to learn rapidly to develop knowledge and understanding of claims practices Strong organizational skills Ability...