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 (preferred).
  • CRC (preferred).
  • Experience in health insurance or health care setting (preferred).
  • Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail Exchange business (preferred).
Responsibilities
  • 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 generates revenue through premiums paid by its members and focuses on delivering quality care. The company also invests in health and wellness programs aimed at reducing healthcare costs and improving the health outcomes of its members. With nearly 100 years of experience, HCSC distinguishes itself from competitors by its commitment to compassion and a focus on innovative solutions that empower people to lead 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 is expanding its presence with a new office in Houston by 2025.
  • The acquisition of Cigna's Medicare businesses will enhance HCSC's market reach.
  • HCSC's collaboration with Feeding America addresses root causes of hunger.

What critics are saying

  • Integrating Cigna's Medicare businesses may lead to operational inefficiencies.
  • Economic changes in Texas could impact the success of the new Houston office.
  • Regulatory hurdles may affect the Maternal and Infant Health Initiative in New Mexico.

What makes HCSC unique

  • HCSC has nearly a century of experience in the health insurance industry.
  • The company focuses on innovation and quality care to improve member outcomes.
  • HCSC invests in health and wellness programs to reduce healthcare costs.

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