Hcc Coders

Overview

• Perform coding and auditing of professional fee records ensuring compliance with official coding guidelines and standards.
• Validate patient demographics, insurance details, and provider billing classifications for accurate claim submissions.
• Compose physician-friendly feedback and inquiries following prescribed workflows to ensure coding accuracy.
• Analyze and review medical records to ensure accurate code assignment and compliance.
• Maintain a coding production rate of 95% or above with proficiency in ICD-10 and CPT coding.
• Troubleshoot claim editing issues, conduct root cause analysis, and escalate as needed to leadership.
• Work remotely in an autonomous environment, ensuring high productivity and accuracy.
• Collaborate with revenue cycle management team to optimize coding processes and outcomes.

Key Responsibilities & Duties

• Audit and code professional fee records, ensuring compliance with coding standards and guidelines.
• Prepare claims for submission by validating patient and insurance information.
• Provide feedback to providers through compliant and clear communication methods.
• Track coding production rates and maintain a minimum accuracy of 95%.
• Utilize expertise in renal specialty coding to train and audit coding processes.
• Conduct claim editing activities and troubleshoot issues to ensure proper resolution.
• Collaborate with leadership to address escalated issues and optimize workflows.
• Prepare daily coding logs and maintain accurate production tracking.

Job Requirements

• High School Diploma or GED required; additional certifications preferred.
• Minimum of 3 years coding experience; 5 years preferred.
• Approved credential from AHIMA or AAPC, such as Certified Professional Coder.
• Expertise in risk adjustment coding and HCC certified coding credential preferred.
• Proficiency in ICD-10 and CPT coding with a minimum accuracy of 95%.
• Strong analytical skills and ability to work autonomously in a remote environment.
• Experience in renal care or value-based care environments is advantageous.
• Reliable internet connectivity meeting specified speed and latency requirements.