HCC Coding Specialist

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🔥 0 minutes ago

⚜️ Louisiana, North Carolina, +3 more states – Remote

⚜️ Louisiana – Remote 🌲 North Carolina – Remote 🦀 Maryland – Remote 🔔 Pennsylvania – Remote ☕ Washington – Remote

💵 $27 - $41 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Highmark Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1852

🛡️ Insurance

💼 Consulting

📦 Logistics

💰 $5M Grant on 2021-05

Insurance • Consulting • Logistics

Highmark Health is a healthcare company committed to reinventing the healthcare system and improving its services for everyone. The organization offers a broad range of career opportunities across various fields such as clinical care, technology, finance, and marketing. Highmark Health emphasizes diversity, equity, and inclusion in its workforce, creating a supportive environment for employees from all backgrounds. The company has been recognized for its commitment to disability inclusion, diversity, and military-friendly employment. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Health strives to create remarkable healthcare experiences for its customers and employees alike.

📋 Description

• Deliver value to the Health Plan and beneficiaries enrolled in risk-adjusted government programs such as Medicare Advantage and Affordable Care Act programs • Perform HCC coding for Medicare Advantage, ACA, and End Stage Renal Disease projects • Flex between Retro and Prospective coding projects across different HCC models • Analyze physician documentation and interpret it into ICD-10 diagnoses and HCC disease categories • Support Remote Patient Monitoring risk-adjustment projects in compliance with CMS requirements • Follow CMS coding guidelines and Highmark policies and procedures • Maintain RPM coding accuracy and productivity requirements • Assist with regulatory audits by performing first coding reviews and ranking charts • Build partnerships and work within coding teams and internal partners • Participate in ad-hoc departmental projects • Recommend process improvements and efficiencies • Participate in RPM coding educational meetings and the annual coding Summit • Perform other duties as assigned

🎯 Requirements

• 3 years of HCC coding and/or coding and billing experience required • CPC, CRC, CCS, or RHIT certification required • Associate degree in medical billing/coding, health insurance, healthcare, or related field preferred • Critical thinking • Attention to detail • Written and oral presentation skills • Written communication skills • Communication skills • HCC coding proficiency • Proficiency in MS Word, Excel, Outlook, PowerPoint, Microsoft Office Suite, MS365, and Teams • Travel requirement of 0%–25% • Must comply with CMS coding guidelines and Highmark policies and procedures • Must comply with HIPAA, data security guidelines, the company Code of Business Conduct, applicable laws, regulations, and training requirements • Ability to lift up to 10 pounds constantly, 10–25 pounds occasionally, and 25–50 pounds rarely

🏖️ Benefits

• Remote work arrangement • Participation in RPM Coding educational meetings • Annual coding Summit • Professional development through provider education and documentation improvement activities