We are seeking a highly skilled and detail-oriented HCC Coding Analyst to join our healthcare revenue cycle management team. The ideal candidate will have a strong understanding of hierarchical condition categories (HCC) coding, medical billing, and medical record abstraction. In this role, you will ensure accurate documentation and coding of patient records to optimize reimbursement from government programs such as CMS. Your expertise in ICD-9, ICD-10, CPT coding, and DRG assignment will support the efficiency and compliance of the billing process in a dynamic healthcare environment focused on accuracy, compliance, and quality patient care.
Duties
- Review NLP-generated HCC coding output.
- Validate assigned codes against available documentation.
- Identify unsupported, inaccurate, or missing codes.
- Make corrections in the platform or designated workflow.
- Follow customer coding instructions and project guidelines.
- Complete assigned records in accordance with agreed production expectations.
- Utilize EHR systems and EHR management tools for coding, record abstraction, and billing workflows.
- Conduct audits of coded records to identify discrepancies and implement corrective actions to improve coding accuracy.
- Maintain up-to-date knowledge of changes in medical coding standards, CMS regulations, and healthcare policies affecting reimbursement.
- Support revenue cycle management initiatives by ensuring precise coding that maximizes appropriate reimbursements while maintaining compliance.
- Proven experience in medical coding with a focus on HCC coding within a healthcare setting.
- Strong knowledge of ICD-9, ICD-10, CPT coding systems, and DRG assignment processes.
- Familiarity with medical billing procedures, medical records management, and electronic health record (EHR) systems.
- Understanding of CMS guidelines for risk adjustment models and reimbursement policies.
- Excellent attention to detail with the ability to accurately abstract information from complex medical records.
- Knowledge of medical terminology, anatomy, pathology, and clinical documentation practices.
- Prior experience with EHR management for billing and coding is highly desirable.
- Effective communication skills for collaborating with clinicians, billing teams, and auditors.
- Flexible schedule
- Remote work location
Location
Maryland, US
Employment Type
Contractor
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago