Hybrid Risk Adjustment Coder – HCC Expert

CareFirst; Baltimore (MD); Hybrid; USD 51,984 - 95,304; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution programs

Job summary

CareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire.

The role involves verifying diagnosis codes and maintaining coding guidelines. Candidates should have at least 3 years of relevant coding experience and be adaptable to various technology platforms.

Position offers a hybrid work model, allowing some remote work. Salary ranges from $51,984 to $95,304 with a comprehensive benefits package.

Qualifications

• 3 years risk adjustment/hierarchical condition category (HCC) coding experience.
• CCS-Certified Coding Specialist or CPS, CCS-P, CRC Upon Hire Required.
• RHIT - Registered Health Information Technician or RHIA Upon Hire Preferred.

Responsibilities

• Verifies accuracy, completeness, and appropriateness of diagnosis codes.
• Develop and maintain coding guidelines for Commercial, CMS Medicare Advantage.
• Provide guidance and direction to Coding Specialists.

Skills

Adobe Acrobat Professional

Microsoft Word

Microsoft Excel

Claims Processing

Facets

Communication skills

Customer service

Education

Associate's Degree in Health Information Technology

2 years of relevant work experience

Tools

Electronic Medical Record (EMR) systems

Electronic Health Record (EHR) systems

Job description

CareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire.

The role involves verifying diagnosis codes and maintaining coding guidelines. Candidates should have at least 3 years of relevant coding experience and be adaptable to various technology platforms.

Position offers a hybrid work model, allowing some remote work. Salary ranges from $51,984 to $95,304 with a comprehensive benefits package.