CERIS Certified Coder I
Fort Worth, TX jobs
CERIS is seeking a Certified Coder. The CERIS Certified Coder reverse code previously coded medical bills to determine coding accuracy.
This is a remote role.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claim and processes based on state rules and regulations
Determine validity and compensability of the claim using CorVel proprietary programs
Make recommendations to referring office
Communicate claim status with 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
Additional duties/responsibilities as assigned
Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA compliance
KNOWLEDGE & SKILLS:
Ability to learn rapidly to develop knowledge and understanding of claims practice
Strong organizational skills
Ability to meet or exceed performance competencies
Effective and professional communication skills
Ability to handle stressful situations, and use critical and strategic thinking
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 Suite, especially Excel and Outlook
EDUCTION & 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
EncoderPro software 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.
Pay Range: $42,899 - $64,162
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
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 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.
#LI-Remote
Medical Only Claims Specialist
Franklin, TN jobs
The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers' compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel.
.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claims, confirms policy coverage and acknowledgement of the claim
Determines the validity and compensability of the claim
Establishes reserves and authorizes payments within established reserving authority limits
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Additional duties as assigned
KNOWLEDGE & SKILLS:
Excellent customer service skills
Excellent written and verbal communication skills
Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
Strong interpersonal, time management, and organizational skills
Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
Bachelor's degree or a combination of education and related experience
Minimum of 1 year industry experience and claim handling
WC experience required
Licensed as required jurisdictionally
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.
Pay Range: $16.36 - $26.31 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
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 CORVEL:
CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States 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.
#LI-Remote