Hierarchical Condition Category (HCC) Coding Specialist

Location: Remote, working from home in Pennsylvania

Company

hirify.global provides health plan services and supports risk-adjusted government healthcare programs.

What you will do

• Perform HCC coding for Medicare Advantage, ACA, and End Stage Renal Disease projects across retrospective and prospective coding models.
• Analyze physician documentation and electronic medical records, translating clinical information into ICD-10 diagnoses and HCC disease categories.
• Maintain coding accuracy and productivity for Remote Patient Monitoring projects while following CMS guidelines and company procedures.
• Support regulatory audits through first-level chart coding reviews and chart ranking.
• Collaborate with physicians, coding teams, Quality, Compliance, Enterprise partners, and leadership.
• Recommend process improvements and participate in coding education meetings and the annual coding summit.

Requirements

• At least 3 years of HCC coding and/or coding and billing experience.
• Critical thinking and strong attention to detail.
• Written and oral presentation and communication skills.
• Proficiency with Microsoft Office, including Word, Excel, Outlook, PowerPoint, MS365, and Teams.
• One of the following certifications is required: CPC, CRC, CCS, or RHIT.
• Must work remotely from Pennsylvania.

Culture & Benefits

• Remote, office-based work arrangement.
• Travel requirement of 0%–25%.
• Opportunity to participate in coding education meetings and an annual coding summit.
• Work is performed under HIPAA, privacy, information security, and business conduct requirements.
• Physical requirements include occasional lifting of up to 25 pounds and rare lifting of up to 50 pounds.