HCC Coding Specialist
Our Mission: Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.
Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.
Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!
Codes will be sequenced and assigned from ICD 9 / ICD 10 based on the code which most accurately describes each documented diagnosis. Coder will develop, maintain and prioritize the logistics schedule of retrieving medical records for the health plan. Conducts medical charts and claims audits, identifying opportunities for improving individual member risk adjustment score accuracy.
- Comprehensive understanding of HCC Coding rules, regulations and methodology
- Accurately and efficiently conduct medical record review/abstraction services.
- Communicates with physicians and office staff on records needed for chart chases.
- Perform work duties remotely, working on site as necessary for additional training and on-going education.
- Must have comprehensive understanding of: the contents of a typical medical chart, medical terminology and abbreviations, ICD 9 / ICD 10 coding conventions and guidelines, what constitutes adequate substantiation of a diagnosis, and appropriate providers, documents and facilities for proper code capture.
Education / Experience / Other Requirements
- Clinical training (Medical Assistant, Registered Nurse, Licensed Practical Nurse, or Certified Nursing Assistant) preferred
- College degree preferred
Years of Experience:
- At least three (3) years of coding experience;
- Clinical experience also preferred
- Certified as CPC, CCS, CCS-P, CCS-H, CPMA or RHIT
- Knowledge of anatomy and physiology/major disease processes/pharmacology
- Knowledge of understanding etiology, pathology, signs and symptoms, diagnostic studies and treatment modalities
- Ability to work remotely from home (maintaining high speed internet as required). ? Knowledge of CMS and Commercial Health Plans
- Strong customer service skills and techniques.
- Strong knowledge of HEDIS measures and their requirements
- Strong oral and written communication skills.
- Strong knowledge of risk adjustment/HCC coding
- Ability to effectively interact with staff, customers and management at all levels.
- Maintains agreed upon work schedule
- Demonstrates flexibility and willingness to embrace change