Hcc Coders

Overview

• Perform professional fee coding and auditing to ensure compliance with industry standards and guidelines.
• Validate patient demographics, insurance details, and provider classifications for accurate billing submissions.
• Analyze medical records to assign accurate codes and ensure regulatory compliance.
• Provide constructive feedback to healthcare providers to improve coding accuracy.
• Maintain high coding production rates and accuracy standards in a remote setting.
• Troubleshoot claim issues and collaborate with leadership for resolution.
• Work independently in a remote environment while ensuring productivity and precision.
• Collaborate with revenue cycle teams to enhance coding processes and outcomes.

Key Responsibilities & Duties

• Audit and code professional fee records, adhering to established coding guidelines.
• Prepare claims by verifying patient and insurance information for submission.
• Provide feedback to providers to improve coding accuracy and compliance.
• Track coding production rates and maintain a minimum accuracy threshold of 95%.
• Utilize expertise in renal specialty coding to train and audit coding practices.
• Resolve claim editing issues and escalate unresolved matters to leadership.
• Collaborate with leadership to optimize workflows and address escalated issues.
• Maintain accurate production tracking and prepare daily coding logs.

Job Requirements

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