HCC Coding Specialist

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🔥 17 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $75k - $95k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏥 Medical Billing and Coding

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MedPOINT Management

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1988

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

MedPOINT Management is a California-based healthcare management services organization that supports independent practice associations (IPAs), provider networks, hospitals and contracted health plans with clinical quality, care management, administrative operations and technology solutions. For more than 32 years MPM has provided services including provider network operations, case management, utilization management, claims operations, credentialing, HEDIS/STARs quality measurement and analytics (via Cozeva), call center and financial management, and digital provider portals and resource libraries. The company emphasizes data security and compliance (SOC 2 and HITRUST e1 certifications for its EZ-CAP and Provider Web Portals) and focuses on enabling value-based care, quality improvement, and operational support for providers and payers.

📋 Description

• Review and analyze medical records to assign accurate HCC (Hierarchical Condition Category) codes • Ensure proper documentation of chronic conditions and risk adjustment diagnoses in compliance with CMS guidelines • Conduct retrospective and prospective chart reviews to identify coding gaps and opportunities • Collaborate with physicians and clinical staff to clarify documentation and support coding accuracy • Prepare and submit coding findings and reports to support risk adjustment programs • Stay current with ICD-10-CM coding updates, CMS risk adjustment models, and payer-specific requirements • Support audit processes and respond to coding queries in a timely manner

🎯 Requirements

• Certified Professional Coder (CPC), CRC, or equivalent coding certification required • Minimum 2+ years of experience in HCC coding and/or risk adjustment • Strong working knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment models • Experience with medical record review in a managed care or health plan environment preferred • Proficiency with electronic health records (EHR) and coding software • Exceptional attention to detail and commitment to coding accuracy and compliance • Strong communication skills with the ability to work collaboratively across clinical and administrative teams

🏖️ Benefits

• 401(k) • 401(k) matching • Bonus based on performance • Company parties • Dental insurance • Employee discounts • Free food & snacks • Health insurance • Opportunity for advancement • Paid time off • Parental leave • Savings bank • Training & development • Vision insurance • Wellness resources