HCC Billing and Coding Specialist

Title : HCC Billing and Coding Specialist

Reports to : Director of Revenue Cycle Management

FLSA Status : Non-Exempt

Personnel Supervised : None

POSITION SUMMARY :

Under general supervision the position is responsible for billing, coding, posting, assigning correct payer sources, submitting clean claims to insurances and follow up for on denial claims in order to maximize the revenue cycle through billing and coding expertise. Reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete. Train and educate staff regarding proper billing and coding practices. HCC Coder determines the appropriate ICD10-CM diagnoses codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines for Hierarchical Condition Categories (HCC). HCC Coding is a risk adjustment model designed to estimate future costs for patients. HCC coding relies on ICD-10-CM coding to assign risk scores to patients. The incumbent reviews retrospective medical record documentation and ensures that the codes are appropriately assigned. The outcome will be documentation that accurately and completely captures the clinical picture / severity of illness / complexity of the patient while providing specific and complete information to be utilized in coding, profiling and outcomes reporting of Central Florida Health Care.

MINIMAL QUALIFICATIONS :

• High School Diploma
• Medical Coding Certificate - CPC or CCS certification required
• Excellent interpersonal skills
• Two years' experience using ICD coding, CPT, HCPS or equivalency

RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS include, but are not limited to, the following :

BENEFITS : Competitive Salary

Federal Student Loan Forgiveness :

PSLF - 10-year commitment, 120 loan payments and at the end of the commitment, the remaining loan is forgiven

Excellent medical, dental, vision, and pharmacy benefits

Employer Paid Long-Term Disability Insurance

Employer Paid Life Insurance equivalent to 1x your annual salary

Voluntary Short-Term Disability, additional Life and Dependent Life Insurance are available

Malpractice Insurance

Paid Time Off (PTO) - 4.4 weeks per year pro-rated

Holidays (9.5 paid holidays per year)

Paid Birthday Holiday

CME Reimbursement

401k Retirement Plan after 1 year of service (w / matching contributions)

Staff productivity is recognized and rewarded

PHYSICAL REQUIREMENTS :

American with Disabilities Act (ADA) Statement : External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.