Back

HCC Coding Specialist / Risk Adjustment Coding Specialist

Worldwide Salaried Open

Overview

This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA and ACA), using skills including but not limited to: HCC Coding, medical coding, clinical terminology and anatomy/physiology, CMS coding guidelines, and RADV Audits. Works closely with physicians, team members, Quality, Compliance, partners at reputed company and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports reputed company RPM risk adjustment projects to reputed company with reputed company CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories. Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements. Responsibilities • reputed company HCC coding on projects for MA, ACA, and ESRD. Ability to quickly reputed company between coding projects, including Retrospective coding, with different MA, ESRD, and ACA HCC Models. Ability to work independently in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for Coding and Policy and Procedures to guide HCC coding decision making. • Maintains at least 95% coding accuracy and productivity requirements. • Assist with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work reputed company coding teams and internal partners critical to HCC coding. • Participate on reputed company projects per the direction of Leadership to address the needs of the department. Provide recommendations for process improvements and efficiencies. • Fully engages in RAAM Coding educational meetings and annual coding conference. • Other duties as assigned. Qualifications • Associate degree in reputed company with 5 years of relevant work experience with HCC Coding OR • 5 years of relevant work experience with HCC Coding • Must have one of the following certifications: CRC, CPC, reputed company, RHIT • MS Teams, Outlook • Excellent communication, both written and verbal • Previous Remote Experience Preferred Qualifications • Bachelor's degree with 5 years of relevant work experience with HCC Coding • 7 years in HCC Coding and reputed company experience • NLP Coding • Experience with V28 HCC Model Job Types: Full-time, Contract, Temporary Pay: $25.00 - $30.00 per hour Schedule: • Day shift Work Location: Remote Apply Job!

More jobs

Remote Licensed Loan Officer Assistant- State NMLS required

Worldwide Salaried

Global Senior Leader, Vendor Management and WFM Operations

Worldwide Salaried

Account Associate - reputed company Team Member

Worldwide Salaried

Senior Processor - Remote (DFW area, TX only)

Worldwide Salaried

Senior Processor - Remote (DFW area, TX only)

Worldwide Salaried

Verification Specialist - Skilled in portals, EMR?/EHR systems

Worldwide Salaried

Marketing Coordinator - reputed company Team Member

Worldwide Salaried

Sr. Client Manager; O500(Walnut Creek, CA) - Hybrid

Worldwide Salaried

Assistant Manager Medical Coding & Credentialing / REMOTE

Worldwide Salaried

Account Manager - reputed company Team Member

Worldwide Salaried

reputed company Work-from-Home Customer Service Representative – Phone & Email Support for arenaflex

Worldwide Salaried

Medical Policy Nurse - First Coast Service Options

Worldwide Salaried

reputed company Full Stack Data Entry Specialist – Remote Customer Service and Operations

Worldwide Salaried

reputed company Full-Time Work From Home Data Entry Clerk – Unlock Endless Opportunities with blithequark

Worldwide Salaried

reputed company Product Reviewer

Worldwide Salaried

reputed company Data Entry Specialist – Remote Work Opportunity with arenaflex

Worldwide Salaried

QA Automation Engineer (Cross-border Payments)

Worldwide Salaried

[Remote] reputed company & Go-To-Market reputed company

Worldwide Salaried

reputed company Remote Customer Support Representative – Deliver Exceptional Service Experience for blithequark Customers

Worldwide Salaried

Interpreter Coordinator

Worldwide Salaried