CERIS Certified Coder I

CERIS; Fort Worth (TX); Remote; USD 43,886 - 65,638; Full time

Benefits offered by this job

Medical insurance

Dental insurance

401K and ROTH 401K options

Paid time off

Job summary

A healthcare coding company based in the United States is seeking a Certified Coder to work remotely. The role involves reverse coding medical bills to ensure accuracy, making recommendations on claims, and communicating status updates to stakeholders. Candidates should possess high school education, AAPC certification, and experience in orthopedic coding. The position offers a competitive salary range of $43,886 to $65,638, along with a comprehensive benefits package that includes health insurance, disability coverage, retirement plans, and paid time off.

Qualifications

• 2+ years of experience in orthopedic billing or coding is preferred.
• Experienced in E/M coding and down-coding.
• Familiar with Texas workers' compensation regulations.

Responsibilities

• Receive claims and process based on state rules.
• Determine validity and compensability of claims.
• Communicate claim status to the referring office and stakeholders.
• Maintain HIPAA compliance.
• Assist with complex claims as necessary.

Skills

Ability to learn rapidly

Strong organizational skills

Effective verbal and written communication skills

Leadership skills

Analytical skills

Critical thinking

Proficient in Microsoft Excel

Education

High School diploma or equivalent

Current AAPC certification

CPC certification with AAPC for over 2 years

Tools

EncoderPro software

Job description

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 Details

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 (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

Pay Range: $43,886 – $65,638. CorVel uses a market based approach to pay and our salary ranges may vary depending on location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, 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.

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.

Equal Opportunity Statement

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