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 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 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 - 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: 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: $48,143 – $71,852 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

• Case Review & Coding: Review individual coding cases (estimated 30–45 minutes per case), applying accurate medical codes in line with project guidelines and standards. • Quality Assurance & Data Accuracy: Ensure consistent and accurate application of medical codes following provided guidelines and project standards. • Platform-Based Review: Use a dedicated labeling platform to review, code, and validate cases efficiently. • Feedback & Collaboration: Provide feedback to improve coding guidelines, identify ambiguities in source data, and support the improvement of AI-assisted coding mappings.

Become a part of our caring community The Senior Configuration Professional work focuses on accessing and configuring an application or system that is integrated with business processes/data and IT infrastructure including building modules, developing tables/reports, and creating complex functions. The Senior Configuration Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Configuration Professional responsibilities can include advising the business, evaluating requests, implementing new features and changes, troubleshooting, resolving testing issues, configuring processes and experiences. integrating, developing interfaces, and maintaining documentation. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. This position reports to the Associate Director, Product Management. Additional Responsibilities: - Strategic thinking and planning capabilities; organized and detail-oriented - Ability to use appropriate problem solving, research and analysis tools - Proficient with Data Analysis - Understanding Data and how to interpret and use it - Demonstrated ability to articulate ideas effectively in both written and oral forms (ability to interact effectively with people at all levels within a team both, internal and external) - Enthusiasm and motivation are essential; a confident change-agent; strong selling and presentation skills (oral and written) - Experience facilitating with mixed teams, and indirect matrix teams - Ability to identify gaps in process performance and recommend process improvements - Ability to work with internal support groups to drive business results Use your skills to make an impact Required Qualifications - Must successfully obtain Epic certification within 60 days of completing Epic training; travel is required - Must have 5 or more years of professional experience in Product Management, Health Informatics, Business, Computer Science, Engineering, or a related field OR a bachelor’s degree in one of these fields - Must have at least 2 years of healthcare experience supporting Medicare and/or Medicaid Preferred Qualifications - Epic Healthy Planet Fundamentals for Health Plans Certification or Healthy Planet Link - Working knowledge and experience in healthcare systems - Experience in user provisioning - EPIC analyst certification/accreditations as they related to business functions (utilization management, care management, etc.…) - Previous experience operating in electronic health records (such as Epic, Cerner, etc.…) - Experience building digital capabilities - Results driven - Ability to lead project teams and drive implementation - Knowledge of Humana's internal policies, procedures, and systems Additional Information: Travel Requirements - Must be willing to travel up to 25% annually for stakeholder engagement and product initiatives - Must be willing to travel to Wisconsin 3–5 times within the first 60 days of employment to attend required training and certification classes Work Schedule - Standard work hours are Monday–Friday, 8:00 a.m.–5:00 p.m. EST or CST - Occasional weekend work is required based on business needs Work-At-Home Requirements - WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. - A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. - Satellite and Wireless Internet service is NOT allowed for this role. - A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $97,900 - $133,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 04-30-2026 About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Employment Type: Full timeShift: Description: Holy Cross Health named Forbes America's Best Employer for Healthcare Professionals! Job Summary: Must be a Certified Oncology Data Specialist (active ODS certification required). Will be responsible for providing remote cancer registry operations to include but not limited to abstracting, case finding and follow-up according to CoC and state standards, and timely completion of the organization’s data requests. Highlights: - Day 1 benefits, no waiting period! Comprehensive benefit packages available including medical, dental, vision, paid time off and 403B retirement. - Colleague Referral Program to earn cash and prizes. - Unlimited career growth opportunities. - Please visit our Career Center Home Page for more about our benefits. What You Will Do: - Review all diagnostic reports and the disease index to determine whether a case is eligible. - Enter newly identified cases into the cancer registry database, METRIQ. - Reportable cases should be abstracted within six months of date of first contact and capture all data elements required. - Follow up information is obtained at least annually for all living patients included in the cancer registry database. - Regularly transmit data to the Florida Cancer Data System (FCDS), Rapid Cancer Reporting System (RCRS) and the National Cancer Data Base (NCDB) - Maintains a working knowledge of applicable Federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of conduct, as well as other policies & procedures in order to ensure adherence in a manner that reflects honest, ethical & professional behavior. Education & Qualifications Licensure: - Active Certified Oncology Data Specialist, ODS required - Minimum of an Associate’s degree with completed coursework in Anatomy and Physiology, pathophysiology, medical terminology, and pharmacology and computer basics ​ Minimum Qualifications - Minimum of 1-3 years varied experience in cancer registry, including abstracting duties, and experience working in a commission on cancer accredited facility. - Proficient knowledge and extensive experience with STORE; Site Specific Data Item Manual, AJCC Staging, knowledge of the SEER and NAACCR Standards; knowledge of state reporting requirements. - Direct experience with ACoS survey under the current standards is required. - Proficient with various Cancer Registry software- i.e., Metriq; Oncolog; ERS, Rocky Mountain; CNext; Abstract Plus. - Experience with electronic health records, EPIC and Mosaiq,is preferred. - Ability to consistently code at 95% threshold for both accuracy and quality while maintaining Trinity Health production and/or quality standards. - Ability to communicate effectively in a variety of settings including with colleagues, medial staff, other hospital departments, and act as a change agent to implement operational efficiencies. - Proficient knowledge of MS Office including Word, Excel and PowerPoint. Ministry/Facility Information: - A member of Trinity Health, one of the largest multi-institutional Catholic health care delivery systems in the nation, Fort Lauderdale-based Holy Cross Hospital, dba Holy Cross Health, is a full-service, not-for-profit, Catholic, teaching hospital operating in the spirit of the Sisters of Mercy. We are the only not-for-profit Catholic hospital in Broward and Palm Beach counties. Through strategic collaborations and a commitment to being a person-centered, transforming, healing presence, the 557-bed hospital offers progressive inpatient, outpatient and community outreach services and clinical research trials to serve as our community’s trusted health partner for life. - We are committed to providing compassionate and holistic person-centered care. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.