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Everyone at Emanate Health plays a vital role in the care we deliver. No matter what department you belong to, the work you do at Emanate Health affects lives. When you join Emanate Health, you become part of a team that works together to strengthen our communities and grow as individuals.

On Glassdoor's list of "Best Places to Work" in 2021, Emanate Health was named the #1 ranked health care system in the United States, and the #19 ranked company in the country.

Job Summary

Responsible for the oversight of HCC Program and STAR measures coding related functions. The HCC coding specialist will work with the IPA Director, Health Plan, and MSO personnel on HCC and STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0 and achieves or improves upon 4.0 STAR rating. The HCC coding specialist is responsible for education to external physician offices and works closely with physicians and billers to ensure the appropriate ICD10 and CPT codes submitted for Medicare and Covered CA lines of business. HCC Coding specialist will be responsible to review medical records and claims data to ensure external physicians are documenting correctly and submitting the correct ICD-10/CPT codes. Responsible for summaries and presenting information in a professional and effective manner. Assigns diagnostic/procedural codes to in- patient and outpatient medical records. Ensures that all accounts are coded accurately and timely. Follows-up on un-coded accounts. Researches and helps resolve problem accounts.

Job Requirements

a.Minimum Education Requirement :

Associate degree preferred; college degree preferred with coursework in Medical Terminology, Anatomy & Physiology and Computer experience.

b.Minimum Experience Requirement :

Must have at least one year of experience in Medicare HCC program within IPA, HMO, or clinic setting. Two to five years of coding experience using ICD-9, ICD-10 and CPT coding systems. Excellent customer service skills required.

c.Minimum License Requirement :

CMC, CCS, CPC, or COC required.

Delivering world-class health care one patient at a time.

Pay Range: