Top 56 Health information coder Jobs in Pennsylvania

Hierarchical Condition Category (HCC) Coding Specialist
Highmark Inc. —Pennsylvania
- $27.02 - $41.85 an hour
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Coder I
The Center for Orthopedic and Research E —West Chester, PA
- Full-time
- Remote
- Urgent Care
- Mid-level
- 3 years
- Paid holidays
- Health insurance
Quick Apply
Facility, Inpatient and Outpatient Coding Tech
Children’s Hospital of Philadelphia —Philadelphia, PA
- $37.99 - $42.73 an hour
- 8 hour shift
- Remote
- Research
- Mid-level
- Children
Quick Apply
Utilization Management & Clinical Validation RN
Optum —Newtown Square, PA
- $60,200 - $107,400 a year
- Full-time
- Remote
- Nursing
- RN License
- Word processing
7d
Medical Policy & Coding Project Consultant- RN/CRNP
Capital Blue Cross —Harrisburg, PA
- $72,870 - $137,290 a year
- Full-time
- Remote
- Nursing
- Microsoft Access
- Writing skills
- Paid holidays
- Health insurance
6d
Coder III - Technical (Interventional Radiology and Cardiovascular Coding)
UPMC —Pittsburgh, PA
- $21.14 - $35.13 an hour
- Full-time
- Remote
- 3 years
- High school diploma or GED
- Senior level
Coder II - Technical (Inpatient Coding)
UPMC —Pittsburgh, PA
- $20.20 - $32.01 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Medical terminology
Investigator
Highmark Inc. —Pennsylvania
- $62,700 - $97,200 a year
- Full-time
- Remote
- Nursing
- Writing skills
- HIPAA
2d
HIM Coder III- PRN
Wellspan Health —York, PA
- Part-time
- Anatomy knowledge
- Computer literacy
- Data analysis skills
7d
Coder II- Radiology
Wellspan Health —York, PA
- Full-time
- Surgery
- Computer literacy
- Mid-level
- Paid parental leave
- Health insurance
6d
Coder III- Cardiology
Wellspan Health —York, PA
- Part-time
- Surgery
- Computer literacy
- Mid-level
- Paid parental leave
- Health insurance
Coder
Commonwealth Health —Wilkes-Barre, PA
- Full-time
- Anatomy knowledge
- Hospital
- Computer literacy
Quick Apply
Coder II- ObGyn
Wellspan Health —York, PA
- Full-time
- Surgery
- Computer literacy
- Mid-level
- Paid parental leave
- Health insurance
6d
Coder/Hosp/PRN
Redeemer Health —Meadowbrook, PA
- PRN
- Anatomy knowledge
- Hospital
- Mid-level
- Tuition reimbursement
Supervisor Strategic Risk Adjustment and Quality
Highmark Inc. —Pennsylvania
- $86,400 - $138,600 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- 6 years
Lead Inpatient Coder
Lehigh Valley Health Network —Allentown, PA
- Full-time
- Remote
- Nursing
- Anatomy knowledge
- Bachelor's degree
1d
Emergency Department Coder
St. Luke's University Health Network —Allentown, PA
- Full-time
- Mid-level
- Critical & Intensive Care
- Typing
Sr Compliance Audit & Education Specialist
Temple University Health System —Philadelphia, PA
- Full-time
- 5 years
- HIPAA
- High school diploma or GED
Certified Medical Coder
UNITED WOUND HEALING PS —Yeadon, PA
- $25 - $33 an hour
- Overtime
- Microsoft Outlook
- Customer service
- Pass drug screening
- AD&D insurance
- Paid holidays
Quick Apply
Clinical Documentation Specialist (40 hrs/Temple Physicians Inc.)
Temple University Health System —Philadelphia, PA
- Full-time
- Mid-level
- 3 years
- Organizational skills

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Hierarchical Condition Category (HCC) Coding Specialist

Highmark Inc. -
Pennsylvania

Apply Now

Job Details

Full-time
$27.02 - $41.85 an hour

Qualifications

Optimizing workflow processes
Affordable Care Act (ACA)
Microsoft Excel
Regulatory compliance evaluation
Microsoft Outlook
Medicare
Data validation techniques
Remote patient monitoring
CMS
Physiology knowledge
Mid-level
RHIT
Certified Professional Coder
CMS regulatory compliance
Retrospective medical coding audits
Medicare regulations
Continuous improvement
Electronic health record (EHR) management for billing and coding
Decision making
Certified Coding Specialist
Health record chart audits
Microsoft Teams
Centers for Medicare & Medicaid Services (CMS) billing regulations
Certified Risk Coder (CRC)
Clinical documentation standards
Training
Associate's degree
Medical terminology
Documentation review
Communication skills

Full Job Description

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with physicians, team members, Quality, Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories. Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements.

ESSENTIAL RESPONSIBILITIES

Performs HCC coding on projects for MA, ACA, and End Stage Renal Disease (ESRD). Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for Coding and Highmark’s Policy and Procedures to guide HCC coding decision making. Maintains RPM coding accuracy and productivity requirements.
Assists with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work within coding teams and internal partners critical to HCC coding.
Participates on ad-hoc projects per the direction of Leadership to address the needs of the department. Provides recommendations for process improvements and efficiencies.
Engages in RPM Coding educational meetings and annual coding Summit.
Other duties as assigned.

EDUCATION

Required

None

Substitutions

None

Preferred

Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.

EXPERIENCE

Required

3 years HCC coding and/or coding and billing

Preferred

5 years HCC coding and/or coding and billing

LICENSES or CERTIFICATIONS

Required (any of the following)

Certified Professional Coder (CPC)
Certified Risk Coder (CRC)
Certified Coding Specialist (CCS)
Registered Health Information Technician (RHIT)

Preferred

None

SKILLS

Critical Thinking
Attention to Detail
Written and Oral Presentation Skills
Written Communications
Communication Skills
HCC Coding
MS Word, Excel, Outlook, PowerPoint
Microsoft Office Suite Proficient/ - MS365 & Teams

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Remote Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$27.02

Pay Range Maximum:

$41.85

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at [email protected]

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

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Refine Your Search

health information coder jobs in pennsylvania

Hierarchical Condition Category (HCC) Coding Specialist

Coder I

Facility, Inpatient and Outpatient Coding Tech

Utilization Management & Clinical Validation RN

Medical Policy & Coding Project Consultant- RN/CRNP

Coder III - Technical (Interventional Radiology and Cardiovascular Coding)

Coder II - Technical (Inpatient Coding)

Investigator

HIM Coder III- PRN

Coder II- Radiology

Coder III- Cardiology

Coder

Coder II- ObGyn

Coder/Hosp/PRN

Supervisor Strategic Risk Adjustment and Quality

Lead Inpatient Coder

Emergency Department Coder

Sr Compliance Audit & Education Specialist

Certified Medical Coder

Clinical Documentation Specialist (40 hrs/Temple Physicians Inc.)

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