Remote HCC Coding Validation Analyst

HealthCare Resolution Services; Columbia (MD); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Flexible schedule

Remote work

Job summary

HealthCare Resolution Services seeks an experienced HCC Coding Analyst to ensure precise documentation and coding of patient records for optimal CMS reimbursement. You will review NLP outputs, validate codes, and correct discrepancies within a remote healthcare revenue cycle setting.

The role requires strong knowledge of ICD-9/10, CPT, DRG processes, and EHR systems, with meticulous attention to detail and effective communication with clinicians and auditors.

Qualifications

• Proven experience in medical coding with a focus on HCC coding within a healthcare setting.
• Strong knowledge of ICD-9, ICD-10, CPT coding systems, and DRG assignment processes.
• Familiarity with medical billing procedures, medical records management, and electronic health record (EHR) systems.
• Understanding of the CMS guidelines for risk adjustment models and reimbursement policies.
• Excellent attention to detail with the ability to accurately abstract information from complex medical records.
• Knowledge of medical terminology, anatomy, pathology, and clinical documentation practices.

Responsibilities

• Review NLP-generated HCC coding output.
• Validate assigned codes against available documentation.
• Identify unsupported, inaccurate, or missing codes.
• Make corrections in the platform or designated workflow.
• Follow customer coding instructions and project guidelines.
• Complete assigned records in accordance with agreed production expectations.
• Utilize electronic health record (EHR) systems and electronic health records (EHR) management tools for coding, record abstraction, and billing workflows.
• Conduct audits of coded records to identify discrepancies and implement corrective actions to improve coding accuracy.
• Maintain up-to-date knowledge of changes in medical coding standards, CMS regulations, and healthcare policies affecting reimbursement.
• Support revenue cycle management initiatives by ensuring precise coding that maximizes appropriate reimbursements while maintaining compliance.

Skills

HCC coding

Medical coding

Attention to detail

Communication skills

EHR navigation

Tools

EHR systems

Coding platforms

Job description

HealthCare Resolution Services seeks an experienced HCC Coding Analyst to ensure precise documentation and coding of patient records for optimal CMS reimbursement. You will review NLP outputs, validate codes, and correct discrepancies within a remote healthcare revenue cycle setting.

The role requires strong knowledge of ICD-9/10, CPT, DRG processes, and EHR systems, with meticulous attention to detail and effective communication with clinicians and auditors.