Senior HCC Coding Specialist

Job not on LinkedIn

🔥 16 hours ago

🏈 Alabama, Alaska, +45 more states – Remote

🏈 Alabama – Remote 🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🏛️ District of Columbia – Remote 🐊 Florida – Remote 🌺 Hawaii – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $68.4k - $105.9k / year

⏰ Full Time

🟠 Senior

🏥 Medical Billing and Coding

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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 accurate risk-adjustment coding value for Medicare Advantage and Affordable Care Act health-plan beneficiaries • Analyze physician documentation and interpret it into ICD-10 diagnoses and HCC disease categories • Conduct medical-record reviews and summarize documentation opportunities • Perform quality reviews of high-risk and incremental HCCs • Collaborate on data collection, coding quality, provider education, and outreach • Develop and present process-improvement and training initiatives • Complete provider and provider-group coding-trend analytics and deliver external presentations • Perform HCC coding for MA, ACA, and ESRD projects across Retro and Prospective models • Support RADV audit coding reviews, claims-data analysis, chart ranking, and submission preparation • Execute assigned projects and participate in ad-hoc departmental projects • Mentor new hires and coworkers and develop onboarding and training materials • Support external vendor quality reviews and report findings

🎯 Requirements

• Associate's degree in medical billing/coding, health insurance, healthcare or related field, or relevant experience and/or education as determined by the company in lieu of degree • 3 years in HCC risk adjustment coding experience • One of the following required certifications: Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) • Experience with HCC coding for MA, ACA, and ESRD projects • Knowledge of CMS coding guidelines and Highmark policies and procedures • Knowledge of medical terminology • Strong clinical knowledge related to chronic illness diagnosis, treatment, and management • Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, PowerPoint, MS365, and Teams • Critical thinking and attention to detail • Strong verbal and written communication, including presentation skills • Project management and problem-solving abilities • Ability to work collaboratively with minimal supervision

🏖️ Benefits

• Remote work arrangement • Travel requirement of 0%–25%