Job 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.
Job is remote.
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
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 necessaryMaintains 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 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
Education & Experience
High School diploma or equivalent
Current AAPC certification (must be maintained throughout employment)
Certification as CPC with the AAPC for more than 2 years (with 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
Pay Range
Pay rates are established taking into account wage requirements, location differential, job-related skills, experience, qualifications, internal equity, and market conditions. For leveled roles new hires may be slotted into a different level, either up or down, based on assessment during interview process. Pay Range: $48,143 - $71,852
Benefits
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) with 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, and paid time off.
EEO Statement
CorVel is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable.
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