[Hiring] HCC Certified Coder @Monogram Health

Role Description

The HCC Certified Coder will be responsible for abstracting clinical information and assigning appropriate diagnosis and procedure codes in accordance with nationally recognized coding guidelines. The HCC Certified Coder will analyze and translate medical and clinical documentation in alignment with the CMS Risk Adjustment Models. The successful candidate will collaborate closely with the coding team and providers to ensure accurate and compliant documentation and coding practices.

• Perform coding for patient health assessments, conduct peer coding quality reviews, and support provider and coding team training and education.
• Conduct prospective medical chart audits to identify, monitor, and document claims and encounter coding related to Hierarchical Condition Categories (HCC).
• Perform coding abstraction and medical chart quality audits to ensure clinicians have accurate clinical documentation to support ICD-10 codes and are adhering to CMS Risk Adjustment guidelines.
• Educate clinicians on coding opportunities identified in chart reviews and keep them informed of current coding and documentation guidelines.
• Perform accurate and timely coding (CPT, ICD-10, HCPCS, modifiers).
• Provide timely correspondence with providers regarding clinical documentation opportunities and queries.
• Identify trends through data analysis or chart review, reviewing existing policy for accuracy and developing new policies and recommends solutions to meet objectives.
• Maintain a minimum of 95% coding accuracy and meet established productivity standards.
• Stay current with regulatory, documentation, and coding guidelines, demonstrating proficiency in CPT, ICD-10, and HCPCS coding, as well as E/M code assignment, auditing, and education.

Qualifications

• High school Diploma or GED required.
• CPC, CRC, CCS, or CCS-P credentials required.
• Minimum of three (3) years of experience in Certified Coder role, including experience in HCC coding.
• Proficiency with Microsoft Word, Excel, PowerPoint, and Electronic Medical Records.
• Demonstrate advanced knowledge of medical terminology, anatomy, and physiology.
• Experience communicating & working closely with Physicians.
• Able to work remotely with proven ability to prioritize tasks, meet goals and deadlines.
• Experience in Medicare programs and regulations including fraud and abuse and Risk Adjustment.
• Familiar with STARs performance measures and metrics.
• Experience with Athena, medical billing, and coding Nephrology are preferred skills.

Benefits

• Comprehensive Benefits: Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts.
• Financial & Retirement Support: Competitive compensation, 401k with employer match, and financial wellness resources.
• Time Off & Leave: Paid holidays, flexible vacation time/PSSL, and paid parental leave.
• Wellness & Growth: Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts.