Remote HCC Coding Specialist - Risk Adjustment Expert

Highmark Health; South Dakota Park (SD); Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD coding projects. The role requires CMS guidelines knowledge and experience with RPM coding and audits.

The candidate will collaborate with physicians, Quality, Compliance, and leadership to ensure accurate risk adjustment coding, documentation improvement, and process enhancements while adhering to HIPAA and privacy policies.

Qualifikationen

• 3 years HCC coding and/or coding and billing
• Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.
• Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT) certifications
• Proficient in MS Word, Excel, Outlook, PowerPoint and MS Office Suite

Aufgaben

• Performs HCC coding on projects for MA, ACA, and ESRD, with various models and systems.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects to address department needs and improve processes.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Kenntnisse

HCC Coding

Attention to Detail

Written Communications

Communication Skills

MS Word

Excel

Outlook

PowerPoint

Written and Oral Presentation Skills

Critical Thinking

Ausbildung

CPC

CRC

CCS

RHIT

Tools

MS365 & Teams

Jobbeschreibung

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD coding projects. The role requires CMS guidelines knowledge and experience with RPM coding and audits.

The candidate will collaborate with physicians, Quality, Compliance, and leadership to ensure accurate risk adjustment coding, documentation improvement, and process enhancements while adhering to HIPAA and privacy policies.