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

Opportunities with Reliant Medical Group, part of the Optum family of businesses. Join a community-based, multi-specialty, physician-led organization where you will work with talented peers on a common purpose: improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well-being as a team member. Join a team at the forefront of value-based care and discover the meaning behind Caring. Connecting. Growing together. Position Details: - Location: Remote- Worcester, MA - Schedule: Full Time - Department: Medical Coding- Manager Responsible for the supervision and day-to-day instruction of assigned employees and activities to ensure efficient and accurate claims coding and denials. Assists in maintaining department operations and acts as a leader in Manager’s absence. Primary Responsibilities: - Assists Management with the daily operations of the coding and denials teams to ensure efficient productivity and quality standards. Distributes and monitors the flow of work for assigned staff - Directs and supervises assigned personnel including performance evaluations, scheduling, orientation, training, and payroll processing. Makes recommendations on staffing levels, employee hires transfers, promotions, salary changes, discipline, terminations, and other similar actions. Resolves grievances and other personnel problems within position responsibilities - Coordinates and prioritizes the assignment of tasks and helps resolve technical and operational problems. Evaluates the impact of solutions to ensure goals are achieved - Provides effective direction, guidance, and leadership over the staff for effective teamwork and motivation, and fosters the effective integration of efforts with organization-wide initiatives - Provides training and technical assistance to employees within assigned work area - Assists Manager in ensuring that assigned employees are provided with appropriate resources and materials - Ensures appropriate follow-up of coding-related payor rejections and denials. Monitors and communicates trends to Manager - Performs quality control checks on charge documents/encounter forms in preparation for charge entry - Maintains and reports on productivity, quality standards and processing timelines as established by Revenue Operations Metrics - Responds to coding related inquiries from providers and support staff and others, as requested - May perform the duties of the Coding Specialist, as needed, due to employee absence or business need. Coordinates team member time off in a manner the does not negatively impact necessary daily functions - Must keep abreast of governmental and other payor coding and reimbursement rules and requirements - Ensures compliance with payor filing deadlines - Adheres to all governmental and third party compliance issues as directed. Cooperates fully with all governmental and third party insurer audits - Ensures compliance with regulatory agencies. Develops and maintains procedures necessary to meet regulatory requirement - Ensures that assigned area comply with established policies, quality assurance programs, safety, and infection control policies and procedures - Ensures adequate equipment and supplies for assigned area - Ensures compliance to all health and safety regulations and requirements - Enhances professional growth and development through educational programs, seminars, etc. - Performs similar or related duties as required or directed - Regular, reliable and predicable attendance is required You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School graduate - Certified Coder: CPC, CCS-P - Demonstrated leader with 3+ years of supervisory experience - 3+ years of professional experience, including 2+ years of experience in a managerial/supervisory role - Proficient in billing software within 6 months - Extensive knowledge of third party billing and payors, coding principles and denials and appeals processes - Thorough knowledge of medical terminology and ICD-10 and CPT4 coding - Solid computer and office skills including phone, keyboard, computer and computer applications, MSOffice, Internet, and E-mail Preferred Qualifications: - EPIC experience - Proven excellent problem-solving ability - Ability to multi-task in a fast-paced environment - Solid analytical ability with excellent organizational and communication skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Advantia is seeking a Claims Resolution Specialist specializing in Lab Billing to join our team! As a Claims Resolution Specialist (Lab Billing), you will be essential in ensuring the accuracy and timeliness of billing and reimbursement for medical services. This important role demands a solid understanding of medical terminology, coding, and billing procedures. This role will report to the RCM Manager. Job Responsibilities: - Initiating ERA (electronic remittance advice) set up with clearinghouse and/or third-party portals. - Initiating EFT (electronic funds transfer) set up with payers & third-party portals. - Assist in vendor support of daily cash reconciliation duties. - Clear understanding of RCM Payment Posting Processing (ERA/Manual Posting) of Line-Item Payments/Denials. - Clear understanding of reconciling offset/recoupment payer remits. - Call carriers and third parties to resolve unidentified payments/reconcile items. - Responsible for maintaining payer portal admin and employee registration. - Assist the RCM Manager with various projects. Job Requirements: - High School/GED Education required - Previous experience in medical billing or a related field is preferred. - Proficiency in electronic health records and billing software preferred. - Athena experience required. Benefits & Compensation: - Health, Dental, and Vision Insurance - Health Savings Account (HSA) and Flexible Savings Account (FSA) Option - 401k Retirement Plan - Life and Disability Insurances - Paid holidays/PTO Please note: Advantia Health provides unparalleled healthcare to our customers by employing the most highly qualified individuals. If you are selected for further consideration, you will be subject to a background investigation. COVID-19 and Flu vaccination or an approved request for accommodation is required as a condition of employment. Advantia Health is an Equal Opportunity Employer that is committed to global diversity: It is a place where good people want to work, and customers want to continue to engage EOE M/F/D/V.

About the Role Imagine helping patients receive high-quality care without leaving their homes. At DrHouse, we are building a new model of virtual healthcare that is fast, accessible, and centered on both patient and provider experience. DrHouse is seeking board-certified OB/GYN physicians to join our growing telemedicine team. This is a telehealth position open to physicians licensed in Texas (TX). Providers may reside anywhere in Texas, including major metropolitan areas such as Houston, San Antonio, Dallas, Austin, and Fort Worth, as well as rural and underserved communities throughout Texas. This role offers the flexibility to design a schedule that supports work-life balance while delivering high-quality, patient-centered virtual care statewide. We are looking for physicians who bring both clinical excellence and compassion to an innovative telemedicine platform. In this role, you will manage a broad spectrum of clinical cases, including primary care, urgent care, men’s and women’s health, and chronic conditions, all delivered through secure virtual consultations. What You’ll Be Doing - Conduct video-based appointments for non-emergency issues. - Treat patients in internal medicine and related areas such as urgent care, gynecology, and obesity care. - Design personalized treatment plans supported by current clinical guidelines. - Record encounters using our efficient EHR tools for accurate follow-up and prescriptions. - Collaborate remotely with other clinicians to deliver coordinated, high-quality care. - Stay updated on telehealth standards and evolving best practices. Who You Are - MD or DO with board certification in Internal Medicine, Family Medicine, Emergency Medicine, or OB/GYN. - ABOM certification is a plus. - Licensed in multiple U.S. states (ideally including CA, TX, or IL). - Comfortable using digital platforms and practicing in a fully remote environment. - Excellent communicator who connects easily with patients virtually. Nice to Have - Telemedicine experience or strong interest in virtual care. - Passion for obesity and chronic disease management. - Comfort providing preventive and lifestyle guidance. What You’ll Get - Annual salary starting at $210,000, plus potential performance bonuses. - Flexible, fully remote schedule that fits your lifestyle. - Support for state licensing through the IMLC Compact. - 25 days of PTO and room for career growth in a rapidly expanding digital health company. - A diverse, mission-driven community of clinicians committed to equitable healthcare access. At DrHouse, we believe healthcare should be as simple as a click—and that great doctors make that possible. Join us in reshaping how care is delivered.