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Job Summary
Under supervision, this position is responsible for researching and analyzing the medical records when there is a discrepancy in coding. Validating the coding and supporting the department in the reporting of findings. This position audits medical records to ensure compliance with the organizations coding procedures and standards according to the CMS coding guidelines and official ICD9 / ICD10 coding guidelines. Reviews insurance payments and denials and recommends coding corrections.
Ability to travel 20 – 30% of the time in and out of state.
Job Requirements:
- High School Diploma or GED.
- CPC Coding Certification/CPC, CCS, CCSP.
- 2 years medical coding experience.
- Experience with process management.
- PC experience and skills to include Microsoft Offic.
- Verbal and written communication skills.
- Analytical skills.
- Ability to travel 20% - 30% of the time in and out of state.
Preferred Job Requirements:
- Associate or Bachelor’s degree.
- CRC.
- Experience in health insurance or health care setting.
- Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail Exchange business.
- This role will work from home with occasional day travel to client onsite locations and must be based out of the Albuquerque, NM area (must live out of or relocate to NM).
*CA
#LI-Remote
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HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range$39,900.00 - $88,800.00
Top Skills
What We Do
Imagine Something New, Something Different.
Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is the largest customer-owned health insurer in the nation and the fourth largest overall. Operating through our Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas (as well as a variety of affiliates and subsidiaries,) we are expanding access to high-quality, cost-effective health care. We are equipping members with information and tools so they can make the best health care decisions for themselves and their families.
HCSC is continuously recognized as an employer committed to community, diversity and inclusion, training and development.
HCSC is committed to pioneering the health care space in ways as effective as they are creative. If you are passionate about the impact you want to have through your work, with a desire to apply innovative thinking to new and emerging challenges, we encourage you to learn more about HCSC.
Learn about what we stand for, how we work and the difference we’re making in the lives of our 15 million members. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization.
Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
