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Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD-10 diagnoses and HCC disease categories.
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Supervises the daily operations of the HIMS (Health Information Management Services) Inpatient Coder III and Outpatient Coder III teams. Certified Inpatient Coder (CIC) - American Academy of Professional Coders (AAPC) (Required) or.
RemoteExpandUpdated 16 days ago - UpvoteDownvoteShare Job
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Certified Professional Coder Apprentice (CPC-A) OR Certified Professional Coder (CPC) OR Certified Risk Coder Apprentice (CRC-A) OR Certified Risk Coder (CRC) OR Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT.
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Office- or Remote-based. This job will deliver value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines.
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Performs HCC coding on projects for MA, ACA, or End Stage Renal Disease (ESRD) through the assignment of appropriate ICD-10 diagnosis codes under the direction of management; may flex between coding projects with different MA, ESRD, or ACA HCC Models.
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1 year of HCC risk adjustment coding. Associates degree in medical billing/coding, health insurance, healthcare, or related field. 3 years of medical billing/coding, health insurance, and/or healthcare experience.
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Adheres to CMS Guidelines for Coding and Highmark's Policy and Procedures to guide HCC coding decision making. Works closely with team members, and leadership to identify and deliver high quality and accurate risk adjustment coding.
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Build partnerships and work within coding teams and internal partners critical to HCC coding. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
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Registered health information administrator (RHIA),certified coding specialist (CCS),registered health information technician (RHIT),certified professional coder (CPC),certified professional coder-hospital (CPC-H) orregistered nurse (RN) with education and experiential training in medical coding, utilization review, denial management, case management or related functions.
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Must possess an Associate/Diploma Degree in Nursing, or Health Information Technology (HIT) or an Advanced degree in nursing or medical field such as MD, DO, NP/APN or PA. In the absence of a college degree, must have 3 or more years’ experience as an inpatient coder or clinical documentation specialist.
Full-timeRemoteExpandUpdated 16 days ago - UpvoteDownvoteShare Job
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AAPC - Certified Professional Coder's (CPC,) Certified Outpatient Coder (or CPC-HCOC) [formerly CPC-H,] Certified Inpatient Coder (CIC,) or Certified Professional Medical Auditor (CPMA) Board Exam.
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Certifications: Registered Nurse (RN), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H) orCertified Radiology Cardiovascular Coding (CIRCC.
Full-timeRemoteExpandUpdated 15 days ago - UpvoteDownvoteShare Job
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In this Inpatient Facility/HIMS Certified Medical CODER QUALITY ASSOCIATE -Remote position, you bring your 3-5+ years of acute care inpatient coding background, required CCS or CPC or CCS-P, and/or RHIT or RHIA Coding Certification, and make a difference.
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Experience: Completion of the MH Coder I apprenticeship program or 1-2 years' experience coding in an outpatient setting using 3M Coding and/or Optum Reimbursement encoder and CAC products. Required Minimum Knowledge, Skills, and Abilities (KSAs) Education: Associates degree in a science field strongly preferred with completion of an accredited program through AHIMA or AAPC. License/Certifications: CCA, CCS, RHIT, RHIA and/or Certified Professional Coder (CPC), or CPC-A credential required.
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Certified Professional Coder and/or Certified Risk Adjustment Coder certification awarded by American Academy of Professional Coders is required within one year of hire. Job Title: SHP Coding/Auditing Specialist (Remote-Hybrid.
RemoteExpandUpdated 16 days ago
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