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Remote Hcc Medical Coder Jobs in Massachusetts (NOW HIRING)

Massgeneralbrigham

Insurance Coordinator

Boston, MA · On-site +1

$19.37 - $27.71/hr

This position is primarily REMOTE, but may require an on-site meeting once per quarter. The full ... and Physiology Medical terminology and medical coding knowledge desired. -Willingness to ...

YO AI Labs

Technical Writer - Remote

Boston, MA · Remote

$30 - $60/hr

Design realistic technical evaluation tasks using CSVs, PDFs, spreadsheets, code samples, and ... medical devices, or regulated industries. * Strong ability to create precise, testable technical ...

YO AI Labs

Technical Writer - Remote

Boston, MA · Remote

$30 - $60/hr

Design realistic technical evaluation tasks using CSVs, PDFs, spreadsheets, code samples, and ... medical devices, or regulated industries. * Strong ability to create precise, testable technical ...

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Remote Hcc Medical Coder information

What is a remote HCC medical coder?

A Remote HCC Medical Coder reviews medical records to identify and assign accurate diagnosis codes based on Hierarchical Condition Category (HCC) risk adjustment models. This role ensures proper documentation and coding to support accurate reimbursement and compliance with Medicare and insurance requirements. Working remotely, coders use electronic health records (EHR) and coding software to analyze patient data. Certification such as CPC, CRC, or CCS is often required, along with a strong understanding of ICD-10-CM coding guidelines.

What are the key skills and qualifications needed to thrive as a remote HCC medical coder?

To thrive as a Remote HCC Medical Coder, you need expert knowledge of ICD-10-CM coding, risk adjustment models, and medical terminology, typically supported by certification such as CPC, CRC, or CCS. Familiarity with coding software, electronic health record (EHR) systems, and secure remote work tools is essential. Strong attention to detail, self-motivation, and time management are important soft skills for excelling in a virtual, independent setting. These skills and qualities ensure accurate coding, compliance with regulations, and effective collaboration with healthcare teams while working remotely.

What are some common challenges faced by remote HCC medical coders?

Remote HCC Medical Coders often encounter challenges such as interpreting complex medical records without immediate access to providers for clarification and managing productivity targets while working independently. Staying updated on rapidly changing coding guidelines and payer requirements can require ongoing education and adaptability. Successful coders use strong communication skills to resolve queries with team members and clinicians, and rely on proactive organization to meet deadlines. Maintaining data security and patient confidentiality is also especially important in a remote environment.

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For Remote Hcc Medical Coder jobs in Massachusetts, the most frequently searched job titles are:

What job categories do people searching Remote Hcc Medical Coder jobs in Massachusetts look for?

The top searched job categories for Remote Hcc Medical Coder jobs in Massachusetts are:

What cities in Massachusetts are hiring for Remote Hcc Medical Coder jobs?

Cities in Massachusetts with the most Remote Hcc Medical Coder job openings:

Remote Hcc Medical Coder jobs near you
Infographic showing various Remote Hcc Medical Coder job openings in Massachusetts as of August 2026, with employment types broken down into 65% Full Time, and 35% Contract. Highlights an 100% Remote job distribution.

Medical Program Auditor/ Analyst

University of Massachusetts Medical School

Westborough, MA • On-site, Remote

$80K - $95K/yr

Full-time

Re-posted 3 days ago

Job description

Under the general direction of the Associate Director or designee, the Fraud, Waste, and Abuse (FWA) Auditor serves a crucial role in identifying, investigating, and preventing fraud, waste and abuse for Medicaid programs. A major function of this position is to conduct desk and onsite audits across various provider types to ensure compliance with federal and state regulations. The Auditor performs investigative activities to develop leads and detect aberrant billing practices, including data mining, claims analysis, and medical record assessment.

Onsite requirement 1-2 times per month, all other aspects of the job are remote.


Responsibilities:

  • Ensure compliance with federal and state regulations and healthcare FWA industry standards.
  • Perform independent data mining and data analysis utilizing claims data to detect patterns and trends that may uncover fraud, waste, or non-compliant billing practices.
  • Conduct onsite audits as required, to assess the completeness of medical and administrative records and the compliance with applicable regulatory requirements.
  • Prepare detailed audit documentation, summaries of investigative findings, compile case files, calculate sanctions and overpayments based on violations cited.
  • Communicate with providers regarding issues such as general regulatory compliance, audit findings, and the recovery process.
  • Recommend policy, procedure and system changes to enhance investigative outcomes.
  • Update appropriate internal management staff regularly on progress of investigations.
  • Stay current with regulatory updates, coding changes, and industry standards.
  • Identify trends from national fraud-related publications and recommend new or improved strategies to strengthen fraud-detection efforts.
  • Assist with document management, updating case-tracking system and adhering to record retention policies and procedures.
  • Perform other duties as assigned.

Qualifications:

  • Bachelor's degree in business, health care administration, or other related field
  • 4-6 years of related experience in the healthcare industry, business,; with at least two years of experience conducting data mining in the healthcare insurance industry, healthcare claim audits, administrative medical record reviews or other claims analysis related experience
  • Knowledge of CPT, HCPCS and ICD-10 coding, reimbursement and claims processing policies
  • Strong analytical and qualitative skills as well as problem solving skills with the ability to look for root causes and implement workable solutions
  • Ability to interpret and apply law and regulations as it relates to fraud and fraud investigations
  • Ability to multi-task, establish priorities and work independently and collaboratively to achieve audit objectives
  • Proficiency in Microsoft Office applications (Word, Excel, PowerPoint and Access)
  • Excellent Customer service skills with the ability to interact professionally and effectively with providers, clients, and internal stakeholders from all departments
  • Ability to travel within Massachusetts and be on-site as needed for audits

Preferred Qualifications:

Prefer individual possessing any of the following certifications or licensure: CPC or CPMA
Knowledge of state and federal regulations as they apply to public assistance programs

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