Part-time Biller/Coder – Claims Analyst

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<strong>OVERVIEW</strong> <br><br><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><img src="https://aleragroup.icims.com/icims2/servlet/icims2?module=AppInert&action=download&id=144345&hashed=-2046073511" alt="Alera_Color_250x80"></span></p><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="551" data-end="586">Part-time Biller/Coder – Claims Analyst</strong></span><br data-start="586" data-end="589"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="589" data-end="602">Location:</strong> Remote </span></p><p> </p><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Vital Incite, an Alera Group company, is looking to add an experienced <strong data-start="551" data-end="586">Biller/Coder – Claims Analyst</strong> to their team on a part-time basis (approximately 5–8 hours per week with flexible scheduling).</span></p><h3 data-start="1014" data-end="1037"><span style="text-decoration: underline;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">About Alera Group</span></span></h3><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Alera Group was founded in 2017 and has grown to become the 14th largest broker of U.S. business. We are passionate about our clients’ success in the areas of Employee Benefits, Property and Casualty Insurance, and Financial Services. With a network of offices nationwide, our commitment to collaboration allows us to offer national resources combined with local service.</span></p><h2 data-start="1634" data-end="1654"><span style="text-decoration: underline;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Why Alera Group</span></span></h2><ul data-start="1656" data-end="2092"><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;" data-start="1656" data-end="1758"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="1658" data-end="1677">Make an Impact:</strong> Your work supports businesses and individuals in protecting what matters most.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;" data-start="1759" data-end="1847"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="1761" data-end="1778">Grow With Us:</strong> We invest in development, mentorship, and long-term career growth.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;" data-start="1848" data-end="1979"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="1850" data-end="1876">The Collaborative Way:</strong> We believe in accountability, teamwork, and shared success across all offices and lines of business.</span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;" data-start="1980" data-end="2092"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="1982" data-end="2017">National Strength. Local Heart:</strong> Scale, resources, and expertise — with relationships that feel personal.</span></li></ul> <br><strong>RESPONSIBILITIES</strong><br><br><p><span style="text-decoration: underline;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong>Position Summary</strong></span></span></p><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">The Part-time Biller/Coder – Claims & Alert/Trigger Criteria supports Vital Oversight’s continuous monitoring of medical and pharmacy claims by reviewing claims for coding accuracy and reimbursement appropriateness and by developing and maintaining alert and trigger logic that identifies high-risk or outlier claims. This role works collaboratively with claims, clinical, and oversight stakeholders to surface actionable findings that support proactive cost and payment integrity oversight.</span></p><p> </p><p><span style="text-decoration: underline;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong>What You’ll Do / Your Impact</strong></span></span></p><p style="margin: 2pt 0in 0in; line-height: 115%; break-after: avoid; font-size: 13pt; font-family: Cambria, serif; color: #365f91; font-weight: normal;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong><span style="line-height: 115%; color: windowtext;">Claims Review & Payment Integrity</span></strong></span></p><ul><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Review medical and/or pharmacy claims to validate coding accuracy, billed services, and reimbursement appropriateness.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Identify potential coding errors, modifier misuse, payment discrepancies, and outlier reimbursement patterns.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Document clear findings and rationale to support carrier or PBM follow-up and recovery efforts.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Collaborate with claims specialists and clinical stakeholders to ensure findings are actionable.</span></li></ul><p style="margin: 2pt 0in 0in; line-height: 115%; break-after: avoid; font-size: 13pt; font-family: Cambria, serif; color: #365f91; font-weight: normal;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong><span style="line-height: 115%; color: windowtext;">Alert & Trigger Criteria Development</span></strong></span></p><ul><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Develop and maintain trigger logic that identifies high-risk or outlier claims, including cost thresholds by CPT, HCPCS, J-code, or episode of care.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Design triggers for emerging risk patterns such as modifier trends, unusual line splitting, or place-of-service cost anomalies.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Document trigger specifications, including logic, thresholds, rationale, and examples.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Perform quality checks on trigger output to reduce false positives and improve signal quality.</span></li></ul><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong>Documentation & Communication</strong></span></p><ul><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="line-height: 115%; color: windowtext;">Conducts oneself with a high degree of integrity and professionalism.</span></span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="line-height: 115%; color: windowtext;">Creates and maintains positive working relationships through trust, dependability, and collaboration.</span></span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="line-height: 115%; color: windowtext;">Demonstrates strong attention to detail and accountability for accuracy.</span></span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="line-height: 115%; color: windowtext;">Works independently with strong time management and organization skills.</span></span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="line-height: 115%; color: windowtext;">Communicates clearly and effectively in written documentation.</span></span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="line-height: 115%; color: windowtext;">Demonstrates a continuous improvement mindset aligned with Oversight goals.</span></span></li></ul> <br><strong>QUALIFICATIONS</strong><br><br><div><p><span style="text-decoration: underline;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong>What You Bring</strong></span></span></p><p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong>Required</strong></span></p><ul><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Credentials – Active billing/coding credential such as CPC, CCS, CCS-P, RHIA, RHIT, or equivalent<br></span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Experience – 3+ years of experience in medical billing, coding, or claims review</span></li></ul><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong>Preferred Experience </strong><br></span><ul><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Payment integrity, audits, or overpayment recovery<br></span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">High-cost claims and specialty drug billing<br></span></li><li style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Designing rules, edits, or analytics-driven claim flags</span></li></ul></div> <br><strong>ADDITIONAL INFORMATION</strong><br><br><p style="margin: 0px;" data-start="3569" data-end="3694"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="3569" data-end="3586">Compensation:</strong></span><br data-start="3586" data-end="3589"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Hourly range: $50 – $65 per hour</span></p><p style="margin: 0px;" data-start="3569" data-end="3694"> </p><p style="margin: 0px;" data-start="3696" data-end="3850"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="3696" data-end="3709">Benefits:</strong></span><br data-start="3709" data-end="3712"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Alera Group offers comprehensive benefits including medical, dental, vision, life and disability coverage, 401(k), generous PTO, and more.</span></p><p style="margin: 0px;" data-start="3696" data-end="3850"> </p><p style="margin: 0px;" data-start="3852" data-end="3968"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"><strong data-start="3852" data-end="3867">Work Model:</strong></span><br data-start="3867" data-end="3870"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Remote, P</span><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">art-time, approximately 5–8 hours per week with flexible scheduling</span></p><p style="margin: 0px;" data-start="3852" data-end="3968"> </p><p data-start="3975" data-end="4027"><strong><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Professional Development – Alera Group Academy</span></strong></p><p style="margin: 0px;" data-start="4029" data-end="4228"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">At Alera Group, growth isn’t left to chance. Through <strong data-start="4082" data-end="4105">Alera Group Academy</strong>, we provide structured development opportunities designed to help you expand your expertise and build a meaningful career.</span></p><p style="margin: 0px;" data-start="4230" data-end="4254"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">You’ll have access to:</span></p><ul data-start="4255" data-end="4474"><li data-start="4255" data-end="4287"><p style="margin: 0px;" data-start="4257" data-end="4287"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Role-specific learning paths</span></p></li><li data-start="4288" data-end="4323"><p style="margin: 0px;" data-start="4290" data-end="4323"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Leadership development programs</span></p></li><li data-start="4324" data-end="4361"><p style="margin: 0px;" data-start="4326" data-end="4361"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Technical and compliance training</span></p></li><li data-start="4362" data-end="4422"><p style="margin: 0px;" data-start="4364" data-end="4422"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Industry certifications and continuing education support</span></p></li><li data-start="4423" data-end="4474"><p style="margin: 0px;" data-start="4425" data-end="4474"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Peer learning and knowledge-sharing communities</span></p></li></ul><p style="margin: 0px;" data-start="4476" data-end="4585"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Whether you’re deepening technical expertise or preparing for leadership, we’re invested in helping you grow.</span></p><p style="margin: 0px;" data-start="4843" data-end="4899"> </p><p style="margin-bottom: 0in;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected class.</span><br><br></p><p style="margin: 0in;"><span style="font-size: 12.0pt; font-family: 'Aptos',sans-serif;">Alera Group is committed to protecting your privacy. Please review our <u><span style="color: blue;">Privacy Policy</span></u> to understand </span><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt; color: #000000;">what personal information we may collect and use as part of your application process.</span></p><p style="margin: 0in;"> </p><p style="margin: 0in;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">#LI-KC1</span></p><p style="margin: 0in;"><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">#LI-Nationwide</span></p> <br><strong>Location Type</strong><br><br>Remote

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