Remote HCC Coding Specialist – Risk Adjustment Expert

Highmark Health; Kentucky; À distance; USD 37 000 - 58 000; Plein temps

Résumé du poste

Highmark Health is seeking a Remote Risk Adjustment Coder to deliver accurate HCC coding for MA, ACA, and ESRD projects, adhering to CMS guidelines and Highmark policies.

You will review physician documentation, perform coding across retro and prospective models, and support audits, education, and process improvements while collaborating with cross-functional teams in a remote office setting.

Qualifications

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing

Responsabilités

• Performs HCC coding on projects for MA, ACA, and ESRD.
• Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models.
• Works independently in various coding applications and electronic medical record systems to support departmental goals.
• Adheres to CMS Guidelines for Coding and Highmark’s Policy and Procedures to guide HCC coding decision making.
• Maintains RPM coding accuracy and productivity requirements.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Build partnerships and work within coding teams and internal partners critical to HCC coding.
• Participates on ad-hoc projects per the direction of Leadership to address the needs of the department.
• Provides recommendations for process improvements and efficiencies.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Connaissances

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Formation

Associate degree in medical billing/coding or related field

Certified Professional Coder (CPC)

Certified Risk Coder (CRC)

Certified Coding Specialist (CCS)

Registered Health Information Technician (RHIT)

Outils

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Description du poste

Highmark Health is seeking a Remote Risk Adjustment Coder to deliver accurate HCC coding for MA, ACA, and ESRD projects, adhering to CMS guidelines and Highmark policies.

You will review physician documentation, perform coding across retro and prospective models, and support audits, education, and process improvements while collaborating with cross-functional teams in a remote office setting.