CERIS Certified Coder I

CorVel Corporation; Fort Worth (TX); Remote; Full time

Benefits offered by this job

Medical benefits

Dental and Vision insurance

401K and ROTH options

Paid time off

Job summary

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.

Qualifications

• High School diploma or equivalent is required.
• Must maintain current AAPC certification throughout employment.
• Certification as CPC with surgical or office experience is necessary.

Responsibilities

• Receives claims and processes based on state rules.
• Determines validity and compensability of claims.
• Makes recommendations and communicates claim statuses.

Skills

Strong organizational skills

Verbal and written communication skills

Critical and strategic thinking

Leadership and problem solving

Ability to work independently

Proficient in Microsoft Office

Education

High School diploma or equivalent

Current AAPC certification

CPC certification with 2+ years experience

Tools

Microsoft Excel

Microsoft Outlook

Job description

TX - Fort Worth 5128 Apache Plume Rd Suite 400 Fort Worth, TX 76109, USA

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
• E/M coding/down-coding experience
• Texas workers' compensation experience is preferred
• Pain Management/Anesthesia/General Surgery coding experience is preferred

Pay Range

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

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

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 and 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 & Compliance

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

Equal Opportunity Employer. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.