HCC Coding Specialist
HCC Coding Specialist
Posted on :
20-10-2024
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Job Description
Job Summary
- This job will deliver value to the Health Plan and its beneficiaries enrolled in RiskAdjusted 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 Enterprise and leadership to identify and deliver highquality and accurate risk adjustment coding.
- Supports all RPM risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting 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
- Perform HCC coding on projects for MA ACA and ESRD. Ability to quickly flex 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 Highmarks Policy and Procedures to guide HCC coding decisionmaking.
- Maintains at least 95% coding accuracy and productivity requirements.
- Assist with Regulatory Audits by performing the first coding review and ranking of charts.
- Build partnerships and work within coding teams and internal partners critical to HCC coding.
- Participate in adhoc 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 conferences.
- Other duties as assigned.
Required Qualifications
- Associate degree in Healthcare 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 CCS RHIT
- MS Teams Outlook
- Excellent communication both written and verbal
- Previous Remote Experience
Priority Qualifications
- Bachelors degree with 5 years of relevant work experience with HCC Coding
- 7 years in HCC Coding and Healthcare experience
- NLP Coding ( Natural Language Processing)
- Experience with V28 HCC Model
Work schedule:
7:00am3:30pm EST or 8:00am4:30pm EST
ATD Technology LLC is a certified minority woman owned business that creates opportunities to match qualified individuals with client programs while meeting all parties financial and technical goals. ATD is a full service provider with offerings in Contract Permanent and TemptoPerm staffing solutions. We serve Fortune 1000 mid cap and small cap companies in the Commercial Public and Government sectors.
Employment Type
Full Time
Key Skills
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