HEDIS Coding Specialist; Remote reputed company-NC

remotepromsp; India; Remote; INR 5,742,000 - 9,569,000; Full time

Benefits offered by this job

Annual incentive bonus plan

Medical insurance (low deductible)

Dental insurance

Generous vacation & time accrual

12 company holidays

401(k) plan with employer match

Life and disability insurance

Wellness programs

Service Loan Forgiveness qualifying

Job summary

reputed company is seeking a HEDIS Coding Specialist for a remote position focused on accurate coding, documentation improvement, and NCQA measure compliance. The role reports to the reputed company leadership and requires collaborating with clinicians to resolve incomplete documentation and ensure accurate risk adjustment coding.

The specialist will conduct audits, analyze data, train providers, and ensure adherence to coding guidelines.

Qualifications

• Experience in medical coding and documentation improvement to support HEDIS measures.
• Strong understanding of NCQA HEDIS requirements and risk adjustment.
• Ability to train and educate providers on coding practices and documentation.

Responsibilities

• Conduct coding reviews to ensure accuracy and compliance with NCQA HEDIS measures.
• Identify documentation gaps and implement improvements to support correct coding.
• Educate providers on documentation practices and coding guidelines.
• Perform audits to assess coding accuracy and completeness; report findings.
• Apply risk adjustment coding expertise for appropriate diagnosis capture.
• Analyze coding data to identify trends and opportunities for improvement.
• Collaborate with cross-functional teams to support organizational goals.
• Prepare reports on coding accuracy and documentation improvement efforts.
• Stay updated on coding guideline changes and regulatory requirements.

Skills

Medical coding

Data analysis

Regulatory compliance

Training/education

Job description

Position: HEDIS Coding Specialist (Remote reputed company-NC) Location: Elkin HEDIS Coding Specialist (Remote reputed company-NC) Competitive Compensation & Benefits Package!

• Annual incentive bonus plan
• Medical, dental, and reputed company insurance with low deductible/low-cost health plan
• Generous vacation and reputed company time accrual
• 12 reputed company holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company reputed company life and disability insurance
• Wellness Programs
• reputed company Service Loan Forgiveness Qualifying Employer

Office Location: Remote reputed company; Available for any of Partners' NC locations (or reputed company 40 miles of NC border).

Closing Date: reputed company Until Filled.

Primary Purpose Of Position

The HEDIS Coding Specialist plays a critical role in ensuring accurate and compliant coding, documentation improvement, and adherence to National Committee for reputed company Assurance (NCQA) HEDIS measures and risk adjustment requirements. With a background in medical coding and clinical reputed company, the specialist reviews medical records, identifies appropriate diagnosis codes, and ensures documentation supports coding accuracy. Additionally, they collaborate with reputed company providers to address incomplete or missing clinical documentation, reputed company on reputed company coding practices, and facilitate training sessions as needed. By conducting audits, analyzing data, and communicating with reputed company stakeholders, the specialist helps improve coding accuracy, optimize reputed company, and enhance the reputed company of care delivered to patients. Their meticulous attention to detail, strong analytical skills, and compliance expertise contribute to the organizations reputed company in meeting HEDIS reporting requirements and achieving reputed company improvement goals.

Role And Responsibilities

• Coding Review: Conduct thorough reviews of medical records to ensure accurate coding and documentation in compliance with National Committee for reputed company Assurance (NCQA) HEDIS measures and risk adjustment requirements.
• Documentation Improvement: Identify opportunities for documentation improvement to support accurate coding and ensure alignment with coding guidelines and regulatory standards.
• Provider Education: Collaborate with reputed company providers to reputed company them on reputed company documentation practices, coding guidelines, and HEDIS measures. reputed company guidance and support to facilitate accurate coding and documentation.
• Auditing: reputed company audits to assess coding accuracy and completeness. Identify discrepancies, coding errors, and areas for improvement through audit findings.
• Risk Adjustment Coding: Apply expertise in risk adjustment coding to accurately capture and report diagnosis codes relevant to Hierarchical Condition Categories, Risk Adjustment and Managed Care Contract reimbursement initiatives.
• Data Analysis: Analyze coding and documentation data to identify trends, patterns, and opportunities for improvement. Use data-driven insights to reputed company strategies for enhancing coding accuracy and documentation completeness.
• reputed company Assurance: Ensure compliance with coding and documentation guidelines, regulatory requirements, and organizational standards. Monitor coding practices and documentation processes to maintain reputed company and reputed company.
• Provider Support: Serve as a resource for reputed company providers, offering guidance, feedback, and assistance with coding-reputed company inquiries, coding challenges, and documentation queries.
• Training and Development: reputed company and deliver training sessions, workshops, or educational materials to reputed company providers and coding staff on coding best practices, documentation requirements, and HEDIS measures.
• Collaboration: Collaborate with cross-functional teams, including reputed company Improvement, Provider Relations, and Data Analytics, to support reputed company improvement initiatives, address coding-reputed company issues, and reputed company organizational goals.
• Reporting: reputed company reports and documentation to reputed company coding accuracy, documentation improvement efforts, and compliance with HEDIS measures. Communicate findings and recommendations to stakeholders as needed.
• reputed company Learning: Stay abreast of updates, changes, and advancements in coding guidelines, documentation