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Medical Coder

Employer
CorVel Corporation
Location
Pittsburgh, Pennsylvania
Salary
Not Specified
Closing date
Jun 3, 2019

View more

Category
Health and Medical
Job Type
Full Time
Career Level
Not Specified

Job Details

JOB SUMMARY:

The Professional Review Specialist provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills to determine appropriateness of medical care.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

  • Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager.
  • Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans.
  • Appropriately document work and final conclusions in designated computer program.
  • Requires regular and consistent attendance.
  • Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
  • Additional duties as assigned

KNOWLEDGE & SKILLS:

  • Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology
  • Knowledge of applicable fee schedule and or applicable U&C Guidelines
  • Proficient in Microsoft applications and technical aptitude with ability to expand knowledge and proficiency in MedChecks proprietary systems
  • Ability to work independently, follow process guidelines, meet productivity standards and timelines. (Must maintain a score of 98% or higher on performance audits).

EDUCATION/EXPERIENCE:

  • Associates degree or equivalent experience
  • Certified Professional Coder (CPC) Accreditation by the American Academy of Professional Coders (AAPC) or equivalent accreditation by another nationally-recognized coding organization and/or 2+ years of coding and data entry experience.
  • Previous experience in the following areas preferred:
    • Medical bill auditing
    • Knowledge of worker's compensation claims process
    • Prospective, concurrent and retrospective utilization review

Application Instructions:

In order to provide equal employment and advancement opportunities to all individuals, employment decisions at CorVel will be based on merit, qualifications and abilities. Except where required or permitted by law, employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex, national origin, ancestry, citizenship, age, handicap or disability, marital status, medical condition or any other characteristic protected by applicable law. Please be aware that CorVel generally does not review all applications submitted in response to job openings posted on the Internet because of the large volume of responses. Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes.

Company

CorVel is looking for passionate, motivated individuals to join our team of associates and help us be successful by making a positive impact within our organization and for our clients. If you are interested in joining CorVel, review our available opportunities and submit your resume as indicated by the application instructions.

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