CERIS is seeking a MCS Certified Coder. The MCS Certified Coder reverse code previously coded medical bills to determine coding accuracy.
This is a remote position.
Essential Functions & Responsibilities
- Process medical bills to ensure that they adhere to standard billing and coding guidelines, State Fee Schedules and Regulations and client/carrier guidelines.
- Accurately assign ICD-9, ICD-10, E/M, CPT, HCPCS, modifiers and units based on provider and other qualified healthcare professional documentation
- Application of NCCI(National Correct Coding Initiative)Edits and CPT Guidelines
- Determine validity and compensability of the claim using CorVel proprietary programs
- Communicate claim status and make recommendations to referring office
- Read and comprehend all medical reports
- Assists other claims professionals with more complex or problematic claims as necessary
- Stay updated on changes in medical coding guidelines and regulations.
- Additional duties/responsibilities as assigned
- Requires regular and consistent attendance
- 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 and time management skills
- Ability to meet or exceed performance competencies
- Effective and professional verbal and written communication skills
- Strict attention to details and demonstrate analytical skills
- A strong understanding of physiology, medical terms and anatomy
- Mathematical 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 Certified Professional Coding (CPC) certification through the American Academy of Professional Coders (AAPC) required. (Which must be maintained throughout employment as current and active status)
- 2 years medical coding experience preferred
- Current or recent orthopedic billing/coding experience
- Pain Management/Anesthesia/General Surgery coding experience is preferred
- E/M coding/down-coding experience
- EncoderPro software experience a plus
- Workers’ compensation experience is a plus
Production Expectations
- Meet a daily production metric
- Maintain an accuracy rate of 98% or higher
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: $45,958 – $68,590
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
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.
