HCC Coding Specialist

This is a fully remote position, open to applicants in Alabama, +44 more states.

📋 Description

• Provide value to the Health Plan and its beneficiaries enrolled in risk-adjusted government programs, including Medicare Advantage and Affordable Care Act initiatives.

• Conduct HCC coding for Medicare Advantage, ACA, and End Stage Renal Disease projects.

• Alternate between Retro and Prospective coding projects across MA, ESRD, and ACA HCC frameworks.

• Operate independently within coding applications and electronic medical record systems.

• Implement CMS coding guidelines along with Highmark's policies and procedures in HCC coding judgments.

• Uphold RPM coding accuracy and productivity standards.

• Support regulatory audits by conducting initial coding reviews and ranking charts.

• Foster collaborations and work effectively within coding teams and with internal partners.

• Engage in ad-hoc projects as assigned by leadership.

• Offer insights for process enhancements and operational efficiencies.

• Attend RPM coding educational meetings and the annual coding Summit.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Minimum of 3 years of experience in HCC coding and/or coding and billing is required.

• One of the following certifications is necessary: Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT).

• An associate degree in medical billing/coding, health insurance, healthcare, or a related field is preferred.

• Strong critical thinking abilities.

• High attention to detail.

• Proficient written and oral presentation skills.

• Effective written communication capabilities.

• Strong overall communication skills.

• Experience in HCC coding.

• Proficient in MS Word, Excel, Outlook, PowerPoint, Microsoft Office Suite, MS365, and Teams.

• English language proficiency; no additional language requirement.

• Travel requirement: 0%–25%.

🏝️ Benefits

• Comprehensive health benefits package.

• Competitive salary and performance-based incentives.

• Opportunities for professional development and continuing education.

• Flexible working arrangements.