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Coding Compliance Specialist

Health Care Service Corp.
Albuquerque, NM Full Time
POSTED ON 11/20/2024 CLOSED ON 1/19/2025

What are the responsibilities and job description for the Coding Compliance Specialist position at Health Care Service Corp.?

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

Under supervision, this position is 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. This position 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.
Ability to travel 20 – 30% of the time in and out of state.

Job 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 Offic.
  • Verbal and written communication skills.
  • Analytical skills.
  • Ability to travel 20% - 30% of the time in and out of state.

Preferred Job Requirements:

  • 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.
  • This role will work from home with occasional day travel to client onsite locations and must be based out of the Albuquerque, NM area (must live out of or relocate to NM).

*CA

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HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$39,900.00 - $88,800.00

Salary : $39,900 - $88,800

Medical Coding Auditor
University of New Mexico Hospitals -
Albuquerque, NM

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