Senior Hierarchical Condition Category (HCC) Coding Specialist

Job not on LinkedIn

🕒 Yesterday

🏈 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.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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 • Analyze physician documentation and interpret it into ICD-10 diagnoses and HCC disease categories • Support risk adjustment projects in compliance with CMS requirements • Conduct medical record reviews and summarize opportunities to improve provider documentation and coding accuracy • Conduct quality reviews of high-risk and incremental HCCs • Collaborate on data collection, provider education and outreach, and coding quality • Develop and present process improvement and training initiatives • Analyze provider and provider-group coding trends and deliver external presentations • Serve as a point person for provider offices and provide additional training • Perform HCC coding for MA, ACA, and ESRD projects across Retro and Prospective models • Contribute to RADV audit coding reviews and chart submission preparation • Execute assigned projects and participate in ad-hoc 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 year's in HCC risk adjustment coding experience • One of: Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) • Critical thinking • Attention to detail • Strong verbal and written communication skills, including presentation skills • Ability to manage projects to a successful outcome • Strong interpersonal skills • Ability to identify and resolve problems • Ability to work in a fast-paced, collaborative environment with minimal supervision • Extensive knowledge of medical terminology and ability to research coding-related questions • Strong clinical knowledge related to chronic illness diagnosis, treatment, and management • Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, PowerPoint, MS365 and Teams • Compliance with HIPAA, data security guidelines, company policies, and applicable laws • Travel requirement: 0%–25%