CERIS Certified Coder I

CERIS Certified Coder

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 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 (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

Pay Range: $43,886 $65,638

About CERIS:

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!).

A comprehensive benefits package is available for full-time regular employees and includes 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, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.