Hierarchical Condition Category (HCC) Coding Specialist
About the position
The position involves delivering value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage and Affordable Care Act. The role focuses on HCC coding, medical coding, and compliance with CMS guidelines, while collaborating with various stakeholders to ensure accurate risk adjustment coding and support for Remote Patient Monitoring projects.
Responsibilities
ā¢ Perform HCC coding on projects for MA, ACA, and ESRD.
,
ā¢ Flex between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models.
,
ā¢ Work independently in various coding applications and electronic medical record systems.
,
ā¢ Adhere to CMS Guidelines for Coding and Highmark's Policy and Procedures.
,
ā¢ Maintain RPM coding accuracy and productivity requirements.
,
ā¢ Assist with Regulatory Audits by performing first coding review and ranking of charts.
,
ā¢ Build partnerships and work within coding teams and internal partners critical to HCC coding.
,
ā¢ Participate on ad-hoc projects per the direction of Leadership.
,
ā¢ Provide recommendations for process improvements and efficiencies.
,
ā¢ Engage in RPM Coding educational meetings and annual coding Summit.
Requirements
ā¢ 3 years HCC coding and/or coding and billing experience required.
,
ā¢ Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) required.
Nice-to-haves
ā¢ 5 years HCC coding and/or coding and billing experience preferred.
,
ā¢ Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.
Benefits
ā¢ Health insurance coverage
,
ā¢ Dental insurance coverage
,
ā¢ 401k benefit for retirement savings plan
,
ā¢ Paid holidays
,
ā¢ Flexible scheduling options
Apply Now
The position involves delivering value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage and Affordable Care Act. The role focuses on HCC coding, medical coding, and compliance with CMS guidelines, while collaborating with various stakeholders to ensure accurate risk adjustment coding and support for Remote Patient Monitoring projects.
Responsibilities
ā¢ Perform HCC coding on projects for MA, ACA, and ESRD.
,
ā¢ Flex between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models.
,
ā¢ Work independently in various coding applications and electronic medical record systems.
,
ā¢ Adhere to CMS Guidelines for Coding and Highmark's Policy and Procedures.
,
ā¢ Maintain RPM coding accuracy and productivity requirements.
,
ā¢ Assist with Regulatory Audits by performing first coding review and ranking of charts.
,
ā¢ Build partnerships and work within coding teams and internal partners critical to HCC coding.
,
ā¢ Participate on ad-hoc projects per the direction of Leadership.
,
ā¢ Provide recommendations for process improvements and efficiencies.
,
ā¢ Engage in RPM Coding educational meetings and annual coding Summit.
Requirements
ā¢ 3 years HCC coding and/or coding and billing experience required.
,
ā¢ Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) required.
Nice-to-haves
ā¢ 5 years HCC coding and/or coding and billing experience preferred.
,
ā¢ Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.
Benefits
ā¢ Health insurance coverage
,
ā¢ Dental insurance coverage
,
ā¢ 401k benefit for retirement savings plan
,
ā¢ Paid holidays
,
ā¢ Flexible scheduling options
Apply Now