HCC Coding Specialist

TL;DR

HCC Coding Specialist: Performing accurate risk adjustment coding for Medicare Advantage and ACA programs with an accent on ICD10 diagnosis interpretation and CMS guideline compliance. Focus on supporting regulatory audits, analyzing physician documentation, and driving process improvements to ensure high-quality risk adjustment data.

Location: Must be based in Pennsylvania (Remote)

Company

hirify.global is a national health and wellness organization providing comprehensive health insurance and care delivery services.

What you will do

• Perform HCC coding for MA, ACA, and ESRD projects using electronic medical record systems.
• Analyze physician documentation to interpret ICD10 diagnoses and HCC disease categories.
• Assist with regulatory audits by performing initial coding reviews and chart rankings.
• Collaborate with internal teams, physicians, and leadership to improve coding accuracy.
• Participate in ad-hoc projects and provide recommendations for process efficiencies.
• Maintain productivity and accuracy requirements in compliance with CMS guidelines.

Requirements

• Must be based in Pennsylvania.
• 3-5 years of experience in HCC coding and/or coding and billing.
• Active certification: CPC, CRC, CCS, or RHIT.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint, Teams).
• Strong critical thinking and attention to detail.
• Ability to adhere to HIPAA and data security regulations.

Culture & Benefits

• Remote work environment with occasional travel to work sites.
• Focus on professional development through educational meetings and coding summits.
• Commitment to ethical standards and compliance in a large-scale healthcare environment.
• Comprehensive support for risk adjustment projects and provider education.