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 beneficiaries enrolled in government programs that are risk-adjusted, such as Medicare Advantage and Affordable Care Act initiatives.

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

• Alternate between Retro and Prospective coding projects utilizing various MA, ESRD, and ACA HCC Models.

• Work autonomously within coding applications and electronic medical record systems.

• Implement CMS Guidelines for Coding along with Highmark policies and procedures.

• Uphold RPM coding accuracy and meet productivity standards.

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

• Foster relationships and collaborate within coding teams and with internal partners.

• Engage in ad-hoc projects within the department.

• Suggest process enhancements and efficiencies.

• Take part in RPM coding educational meetings and the annual coding Summit.

• Evaluate physician documentation and translate it into ICD10 diagnoses and HCC disease categories.

• Facilitate improvements in documentation, provider education, report analysis, and process enhancements.

⛳️ Requirements

• A minimum of 3 years of experience in HCC coding and/or coding and billing.

• Certification as a Professional Coder (CPC) OR Certified Risk Coder (CRC) OR Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT).

• Expertise in HCC Coding.

• Proficient in MS Word, Excel, Outlook, and PowerPoint.

• Skilled in Microsoft Office Suite, MS365, and Teams.

• Strong critical thinking abilities.

• Meticulous attention to detail.

• Effective written and oral presentation skills.

• Strong written communication abilities.

• Excellent communication skills.

• Capacity to adhere to CMS coding guidelines and company policies.

• Ability to safeguard confidential customer information while complying with HIPAA and data security regulations.

• An associate degree in medical billing/coding, health insurance, healthcare, or a related field is preferred (not mandatory).

🏝️ Benefits

• Opportunity for remote work.

• Participation in the annual coding Summit.

• Travel requirements ranging from 0% to 25%.