• Perform outpatient and/or inpatient facility coding including ICD-10-CM, ICD-10-PCS, CPT/HCPCS, DRG, and E&M for all encounters assigned by VAPORHCS • Access and review health record documentation in VA's VistA/CPRS system; enter codes into the approved coding application • Apply modifiers, CCI bundling guidelines, and Reason Not Billable (RNB) designations as appropriate • Code all standard cases within 7 calendar days of receipt/discharge; priority cases within one business day • Clarify conflicting, ambiguous, or nonspecific documentation; consult VHA coding guidance as appropriate • Comply with all HIPAA, VA/VHA privacy, security, and records management directives, and complete all required VA training prior to system access and annually thereafter • Comply with AHIMA Standards of Ethical Coding • Conduct coding audits covering not less than 5% of coded services; provide written feedback to team members, track quality trends, and report metrics to Arrow ARC PM on a weekly cadence • Ensure team coding production meets contract and program office standards, including a minimum of 70 outpatient or 13 inpatient encounters per coder per 8-hour day, and a 95% accuracy rate per HIMS program office requirements • Serve as primary point of contact for contract team coding questions and VA coding-related inquiries, including documentation clarification, VHA policy, and contract compliance matters • Mentor and support coders transitioning into VA/VHA coding environments; assist with onboarding and ongoing education as needed • Participate in VA-directed coding reviews, pre-bill re-reviews, or RAC/MAC audits as applicable

Role Description 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 the 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 - Assists other claims professionals with more complex or problematic claims as necessary - Maintains HIPAA compliance - Additional duties as assigned Qualifications - 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 (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 is preferred - Pain Management/Anesthesia/General Surgery coding experience is preferred Requirements - 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 Benefits - Comprehensive benefits package for full-time regular employees 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 - Paid time off 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 the 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 Company Description 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!). CorVel is an Equal Opportunity Employer, drug-free workplace, and complies with ADA regulations as applicable.

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve. Job Description: Role Summary: The Medical Coding and Billing Specialist is responsible for writing and maintaining coding and billing rules in the practice management system. The position is also responsible for reviewing and importing daily charges in Radiology Authorization Specialist and daily claim filing. Excellent verbal and written communication skills required. The coding and billing works under the direct supervision of their respective team manager.   Responsibilities: - Review and verify patient insurance coverage and eligibility for proton therapy treatments.  - Verify all applicable charges for proton therapy, radiation therapy, and radiology services are entered timely and accurately into the practice management system for reimbursement.  - Generate and submit accurate and timely claims for proton therapy, radiation therapy, and radiology services to insurance payers.  - Monitor and track claims through the billing process to ensure timely payment and identification of payer roadblocks.  - Assist with investigation and resolution of any claim rejections, denials, or appeals related to proton therapy treatments.  - Review and interpret insurance policies and regulations related to proton therapy treatments to ensure compliance with billing requirements.  - Work collaboratively with the proton therapy center's medical and pre-authorization teams to ensure accurate and complete billing for proton therapy and radiation therapy treatments  - Maintain accurate and up-to-date records of billing activities in patient files and computer systems  - Ability to review and interpret radiation oncology medical records for accuracy as it relates to coding and billing.  Educate clinical team on appropriate documentation requirements.  - Assist team members with responses to patient and insurance company inquiries about billing for proton therapy treatments in a timely and professional manner  - Stay current with industry trends, changes to insurance policies, and other developments that may impact the billing process for proton therapy and radiation therapy treatments.  - Review and verify patient insurance coverage and eligibility for proton therapy treatments as needed.  - Reviews charges in “Approve Failed” status daily for accuracy and corrective action.  - Contacts the appropriate department to follow up on pending issues for insurance and referrals.  - Works Research ACE tasks in Unity daily.  - Reviews charges on “Hold” status daily for accuracy and corrective action.   - Creates new Ace rules/edits as needed to reduce claim denials and/or manual review.  - Maintains Ace rules to ensure data is current.  - Runs Ace edits daily and files paper and electronic claims to the appropriate payors.  - Keeps informed regarding current coding regulations, auditing, professional standards and company/department policies and procedures as it applies to the field of medical oncology and effectively applies this knowledge.  - Communicates effectively with practice leadership regarding coding issues to help ensure coding compliance and minimize denials.  - Demonstrates outstanding work ethic and works cooperatively with all team members and management.   - Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.  Required Qualifications: EDUCATION & EXPERIENCE: - Bachelors degree preferred  - Minimum two years’ experience in charge entry/billing required.   - 1+ year(s) of Prior Authorization experience. - Extensive knowledge of CPT, HCPCS, and ICD-9 coding in addition to insurance billing guidelines required.   - Proficiency in Microsoft EXCEL spreadsheets and strong computer background.    - Medical insurance background required. - Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid PHYSICAL REQUIREMENTS: - Must be willing and able to lift up to 25 pounds. - Must be willing and able to travel to satellite clinics when necessary. Essential Competencies: - Attendance is an essential job function. - Ability to work effectively with all levels of management and other colleagues - Ability to demonstrate initiative and mature judgment. - Ability to demonstrate high degree of professionalism and adaptability. - Ability to demonstrate proficiency in the use of end-user computer applications (MS work, Excel, Outlook), database and patient scheduling and other medical information systems. - Ability to demonstrate strong customer service delivery skills. - Ability to utilize websites, portal and electronic options when available to increase efficiency - Ability to follow oral and written instructions. - Ability to recognize and solve problems using creative thinking skills, hands on problem solving skills and the ability to analyze and respond to data. - Skilled at effective verbal and written communications, including active listening skills and skill in presenting findings and recommendations. - Skilled at Multi-tasking, organizational skills and superb attention to detail. - Working knowledge of Hospice and other payer requirements. - Knowledge of clinic office procedures, medical practice and medical terminology. #LI-REMOTE

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve. Job Description: Role Summary: The Medical Coding and Billing Specialist is responsible for writing and maintaining coding and billing rules in the practice management system. The position is also responsible for reviewing and importing daily charges in Radiology Authorization Specialist and daily claim filing. Excellent verbal and written communication skills required. The coding and billing works under the direct supervision of their respective team manager.   Responsibilities: - Review and verify patient insurance coverage and eligibility for proton therapy treatments.  - Verify all applicable charges for proton therapy, radiation therapy, and radiology services are entered timely and accurately into the practice management system for reimbursement.  - Generate and submit accurate and timely claims for proton therapy, radiation therapy, and radiology services to insurance payers.  - Monitor and track claims through the billing process to ensure timely payment and identification of payer roadblocks.  - Assist with investigation and resolution of any claim rejections, denials, or appeals related to proton therapy treatments.  - Review and interpret insurance policies and regulations related to proton therapy treatments to ensure compliance with billing requirements.  - Work collaboratively with the proton therapy center's medical and pre-authorization teams to ensure accurate and complete billing for proton therapy and radiation therapy treatments  - Maintain accurate and up-to-date records of billing activities in patient files and computer systems  - Ability to review and interpret radiation oncology medical records for accuracy as it relates to coding and billing.  Educate clinical team on appropriate documentation requirements.  - Assist team members with responses to patient and insurance company inquiries about billing for proton therapy treatments in a timely and professional manner  - Stay current with industry trends, changes to insurance policies, and other developments that may impact the billing process for proton therapy and radiation therapy treatments.  - Review and verify patient insurance coverage and eligibility for proton therapy treatments as needed.  - Reviews charges in “Approve Failed” status daily for accuracy and corrective action.  - Contacts the appropriate department to follow up on pending issues for insurance and referrals.  - Works Research ACE tasks in Unity daily.  - Reviews charges on “Hold” status daily for accuracy and corrective action.   - Creates new Ace rules/edits as needed to reduce claim denials and/or manual review.  - Maintains Ace rules to ensure data is current.  - Runs Ace edits daily and files paper and electronic claims to the appropriate payors.  - Keeps informed regarding current coding regulations, auditing, professional standards and company/department policies and procedures as it applies to the field of medical oncology and effectively applies this knowledge.  - Communicates effectively with practice leadership regarding coding issues to help ensure coding compliance and minimize denials.  - Demonstrates outstanding work ethic and works cooperatively with all team members and management.   - Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer.  Required Qualifications: EDUCATION & EXPERIENCE: - Bachelors degree preferred  - Minimum two years’ experience in charge entry/billing required.   - 1+ year(s) of Prior Authorization experience. - Extensive knowledge of CPT, HCPCS, and ICD-9 coding in addition to insurance billing guidelines required.   - Proficiency in Microsoft EXCEL spreadsheets and strong computer background.    - Medical insurance background required. - Expertise in insurance policies and regulations related to medical billing, including Medicare and Medicaid PHYSICAL REQUIREMENTS: - Must be willing and able to lift up to 25 pounds. - Must be willing and able to travel to satellite clinics when necessary. Essential Competencies: - Attendance is an essential job function. - Ability to work effectively with all levels of management and other colleagues - Ability to demonstrate initiative and mature judgment. - Ability to demonstrate high degree of professionalism and adaptability. - Ability to demonstrate proficiency in the use of end-user computer applications (MS work, Excel, Outlook), database and patient scheduling and other medical information systems. - Ability to demonstrate strong customer service delivery skills. - Ability to utilize websites, portal and electronic options when available to increase efficiency - Ability to follow oral and written instructions. - Ability to recognize and solve problems using creative thinking skills, hands on problem solving skills and the ability to analyze and respond to data. - Skilled at effective verbal and written communications, including active listening skills and skill in presenting findings and recommendations. - Skilled at Multi-tasking, organizational skills and superb attention to detail. - Working knowledge of Hospice and other payer requirements. - Knowledge of clinic office procedures, medical practice and medical terminology. #LI-REMOTE