Full-Time

Coding Compliance Specialist

Confirmed live in the last 24 hours

HCSC

HCSC

Health insurance provider in multiple states

Financial Services
Healthcare

Compensation Overview

$39.9k - $88.8kAnnually

Junior, Mid

Remote in USA

Must reside within 250 miles of Albuquerque or anywhere within New Mexico.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
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 Office.
  • Verbal and written communication skills.
  • Analytical skills.
  • 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.
Responsibilities
  • 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.
  • 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.

HCSC provides health insurance services across five states: Illinois, Montana, New Mexico, Oklahoma, and Texas. The company offers a variety of health insurance plans designed for individuals, families, and businesses, ensuring that different healthcare needs are met. HCSC's plans work by collecting premiums from members, which then fund the healthcare services covered under these plans. What sets HCSC apart from other health insurance providers is its strong focus on health and wellness programs aimed at reducing overall healthcare costs and improving the health outcomes of its members. The goal of HCSC is to be a reliable partner in health, promoting quality care and supporting individuals in leading healthier lives.

Company Stage

N/A

Total Funding

$472.7M

Headquarters

Chicago, Illinois

Founded

1936

Simplify Jobs

Simplify's Take

What believers are saying

  • HCSC's acquisition of Cigna's Medicare businesses expands its capabilities in the growing Medicare market.
  • The new Houston office expansion will create job opportunities and drive local economic growth.
  • Rising telehealth adoption allows HCSC to expand its virtual care offerings.

What critics are saying

  • Integration challenges with Cigna's Medicare businesses could affect service delivery and financial performance.
  • Economic downturns in Texas may impact the success of HCSC's Houston office expansion.
  • Increased competition in the Medicare market could impact HCSC's market share.

What makes HCSC unique

  • HCSC's nearly century-long experience establishes it as a trusted health insurance provider.
  • The company offers comprehensive health plans tailored to diverse client needs across five states.
  • HCSC invests in health and wellness programs to reduce costs and improve member outcomes.

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