HCC Coding Auditor & Education Specialist

WelbeHealth; Los Angeles (CA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical insurance coverage

17 days PTO + 12 holidays + sick time

401K savings + match

Advancement opportunities

And additional benefits

Job summary

WelbeHealth is seeking a Coding Auditor and Educator to ensure accurate coding and proper documentation within health records. You will educate teams on best practices and support CMS risk adjustment coding guidelines across PACE programs.

The role requires CCS or CPC credentials, extensive ICD-10 knowledge, and MEAT application experience. A detailed, collaborative approach with the coding team is essential.

Qualifications

• Associates Degree preferred; three (3) years of relevant experience may be substituted in lieu of a degree.
• Minimum of four (4) years of related experience or a combination of healthcare-related education and experience in coding and auditing.
• Minimum of two (2) years of Risk Adjustment (HCC) coding experience in a managed care environment.
• Current CCS, CCS-P, CPC, CPC-H, CPMA, or CRC credential.
• Strong knowledge of ICD-10 coding standards.
• Experience in the correct application of M.E.A.T. concepts.
• Comfortable in Microsoft Office (Outlook, Word, Excel, and PowerPoint)

Responsibilities

• Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants
• Conduct pre-visit chart preparations and post-visit chart reviews
• Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding guidelines
• Work closely with Coding Supervisor in identifying opportunities for HCC coding education

Skills

ICD-10 coding standards

MEAT concepts

Microsoft Office

Risk Adjustment (HCC) coding

Healthcare auditing

Education

CCS/CCS-P/CPC/CPC-H/CPMA/CRC credentials

Tools

MS Office

Job description

WelbeHealth is seeking a Coding Auditor and Educator to ensure accurate coding and proper documentation within health records. You will educate teams on best practices and support CMS risk adjustment coding guidelines across PACE programs.

The role requires CCS or CPC credentials, extensive ICD-10 knowledge, and MEAT application experience. A detailed, collaborative approach with the coding team is essential.