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Medical Coding Hcc Episource Jobs in Kentucky (NOW HIRING)

Sentara Health Plans

$80 - $110/hr

... HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment ... Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • ...

WVU Medicine

$150 - $230/hr

... HCC)capture, and risk adjustment across the continuum of care. This leader serves as the ... EXPERIENCE:**1. Seven (7) years of progressive healthcare leadership.2. Experience in CDI, Coding ...

Tend

$157 - $213/hr

... coding gaps affecting severity of illness, risk of mortality, HCC/risk adjustment, and quality ... Benefits For full time employees, Tendo also offers full health benefits (medical, dental, and ...

StartupNWA

$86 - $110/hr

Washington Regional Med. Ctr. - Fayetteville, AR 72703 Position Type: Full Time Education Level ... The role partners closely with providers, coding, revenue cycle, quality, compliance, and practice ...

Alignment Health

$172 - $259/hr

Data, Methods, and Analytic Excellence Work hands-on with medical/pharmacy claims, enrollment ... Develop and maintain analytic assets (reusable code modules, cohort builders, standardized outcome ...

CVS Health

Nurse Practitioner

Louisville, KY · On-site

$78K - $168K/yr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

CVS Health

Nurse Practitioner

Louisville, KY · On-site

$78K - $168K/yr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

Oak St. Health

Nurse Practitioner

Louisville, KY · On-site

$78K - $168K/yr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

Oak Street Health

Nurse Practitioner

Eastwood, KY · On-site

$78K - $168K/yr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

CVS Health

Nurse Practitioner

Louisville, KY

$240K - $270K/yr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

Oak Street Health

Nurse Practitioner

Eastwood, KY · On-site

$240K - $270K/yr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

NPACE

$126.50 - $148.50/hr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

NPACE

$78 - $169/hr

This role reports to the Center Medical Director and works closely with operational leadership ... Understands HCC (Hierarchical Condition Categories) documentation, ICD-10 (International ...

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All JobsMedical Coding Hcc Episource JobsMedical Coding Hcc Episource Jobs in Kentucky

Medical Coding Hcc Episource information

What is a medical coding HCC specialist at Episource?

Medical Coding HCC (Hierarchical Condition Category) roles at Episource involve reviewing patient medical records to accurately assign diagnosis codes according to HCC guidelines. Coders play a crucial part in ensuring proper risk adjustment and compliance with healthcare regulations, which helps determine reimbursement rates for healthcare providers. These professionals must have a deep understanding of ICD-10-CM coding, medical terminology, and HCC risk adjustment models. At Episource, coders may work remotely or on-site, collaborating with other clinical and operational teams to maintain high standards of data accuracy and integrity.

What skills and qualifications are needed to thrive as a medical coding HCC specialist at Episource?

To thrive as a Medical Coding HCC specialist at Episource, you need a strong understanding of ICD-10-CM coding, risk adjustment, and healthcare regulations, often demonstrated by a relevant certification such as CPC, CRC, or CCS. Familiarity with coding software, electronic health record (EHR) systems, and Episource-specific platforms is typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for ensuring accurate code assignment and collaborating with clinical teams. These skills are essential to maximize coding accuracy, ensure compliance, and support proper reimbursement in value-based care environments.

What are common challenges faced by medical coding HCC specialists at Episource and how can they be addressed?

Medical Coding HCC professionals at Episource often encounter challenges such as interpreting complex medical records, staying updated with evolving coding guidelines, and ensuring accuracy in risk adjustment documentation. To address these, it's important to engage in ongoing training, utilize company-provided resources, and collaborate closely with quality assurance teams. Regular communication with providers and other coders also helps clarify ambiguities and maintain coding accuracy, contributing to both personal development and overall team success.

What is the difference between Medical Coding Hcc Episource vs Medical Coding Specialist?

AspectMedical Coding Hcc EpisourceMedical Coding Specialist
CertificationsAHIMA or AAPC certifications, HCC coding trainingAHIMA or AAPC certifications, general coding credentials
Work EnvironmentHealthcare organizations, insurance companies, remote optionsHospitals, clinics, physician offices, remote work possible
Industry UsageFocus on risk adjustment, HCC coding for Medicare AdvantageGeneral medical coding across various specialties

Medical Coding Hcc Episource specializes in risk adjustment coding, particularly HCC coding for Medicare Advantage plans, often requiring specific training. Medical Coding Specialist roles cover broader medical coding tasks across multiple healthcare settings. While both roles require coding certifications, Hcc Episource focuses on risk adjustment, making it more specialized compared to the general scope of Medical Coding Specialists.

Is medical coding worth it in 2026?

Medical coding, including HCC coding roles like those at Episource, remains a valuable career due to ongoing healthcare industry growth and the demand for accurate medical record documentation. Certified coders with knowledge of coding systems and compliance standards are likely to find stable employment opportunities in the coming years.

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For Medical Coding Hcc Episource jobs in Kentucky, the most frequently searched job titles are:

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Cities in Kentucky with the most Medical Coding Hcc Episource job openings:

Medical Coding Hcc Episource jobs near you

Compliance Coding Auditor

On-site

Sentara Health Plans
See more jobs at Sentara Health Plansexternal

$80 - $110/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description

## Compliance Coding AuditorApplyremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR-104491**City/State**Norfolk, VA**Work Shift**First (Days)**Overview:**# Compliance Coding AuditorPerforms a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines.Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year.All queries arising from the audit process are managed by the Compliance Auditor. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Manager of Audit and Coding Compliance. Works with leadership regarding scheduling of internal and external audits.Education* Associate Level degree preferred but requiredCertification/Licensure* CPC or CCS certification (Required)Experience* 4+ years of experience with multi-specialty coding (Required)* 4+ years of experience with acute care outpatient coding (Required)* Professional fee coding experience (Required)***Remote work opportunity preferred candidates in the Virginia/North Carolina geographic location*** **Benefits: Caring For Your Family and Your Career****•** Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave• Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down – $10,000•Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.**Sentara Health is an equal opportunity employer** and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.In support of our mission “to improve health every day,” this is a tobacco-free environment.**For positions that are available as remote work,** **Sentara Health employs associates in the following states:**Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. #J-18808-Ljbffr

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