CERIS Certified Coder I

About the role

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
• Reads and comprehends all medical reports
• Adheres to client and carrier guidelines and participates in claims review as needed
• Aids other claims professionals with more complex or problematic claims as necessary
• Maintains HIPAA compliance

Knowledge & Skills

• Ability to learn rapidly to develop knowledge and understanding of claims practices
• Strong organizational skills
• Meets or exceeds performance competencies
• Effective and professional verbal and written communication skills
• Handles demanding situations while using critical and strategic thinking skills
• Demonstrated outstanding leadership, problem solving, and analytical skills
• Thinks and works independently, while working in an overall team environment
• Proficient in Microsoft Office, especially Excel and Outlook

Eduction & 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 preferred
• Pain Management/Anesthesia/General Surgery coding experience preferred

Pay

Pay Range: $43,886 – $65,638

Benefits

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.

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!).