This position is posted by Jobgether on behalf of a partner company. We are currently looking for a HEDIS Coding Specialist in United States.
We are seeking a skilled HEDIS Coding Specialist to ensure accurate medical coding and documentation in alignment with HEDIS measures and risk adjustment requirements. This role involves reviewing clinical records, identifying appropriate diagnosis codes, and collaborating with healthcare providers to improve documentation quality. The specialist will conduct audits, analyze coding trends, and support compliance initiatives that enhance patient care and reporting accuracy. With strong attention to detail and proficiency in coding systems, you will help optimize coding performance while contributing to quality improvement initiatives. This position offers opportunities for remote work and engagement with diverse healthcare teams.
Accountabilities:
- Conduct thorough reviews of medical records to ensure accurate coding in compliance with HEDIS and risk adjustment standards.
- Identify opportunities for documentation improvement and provide guidance to healthcare providers.
- Perform audits to assess coding accuracy, identify discrepancies, and recommend corrective actions.
- Apply risk adjustment coding methodologies to capture appropriate diagnosis codes for reporting and reimbursement.
- Collaborate with cross-functional teams to support quality improvement initiatives and coding-related projects.
- Develop and deliver educational sessions or materials to providers and coding staff on proper coding practices.
- Generate reports to monitor coding accuracy, documentation improvement, and compliance with HEDIS measures.
Requirements
- Bachelor’s degree in Health Information Management, Health Information Technology, Nursing, Medical Coding, or related healthcare field; or Associate’s degree with 3+ years of coding experience.
- Minimum 2–3 years of experience in medical coding and documentation; experience with HEDIS measures preferred.
- Certification from AHIMA (CCS, RHIA, RHIT) or AAPC (CPC, CRC); HEDIS certification preferred or obtainable within 6 months.
- Proficiency in ICD-10-CM/PCS, CPT, and HCPCS coding systems; familiarity with EHR systems such as Epic or Cerner.
- Strong analytical skills, attention to detail, and ability to manage multiple coding projects simultaneously.
- Excellent verbal and written communication skills to educate providers and collaborate with internal teams.
- Knowledge of risk adjustment methodologies, Medicare Advantage, and Medicaid managed care operations preferred.
Benefits
- Competitive salary and annual incentive bonus plan.
- Medical, dental, and vision insurance with low deductibles and cost-sharing.
- Generous paid time off, sick leave, and 12 holidays per year.
- State retirement (pension) plan and 401(k) with employer match.
- Company-paid life and disability insurance.
- Wellness programs and support for professional development.
- Public Service Loan Forgiveness qualifying employer.
Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching. When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.
🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.
📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.
🎯 Based on this analysis, we automatically shortlist the 3 candidates with the highest match to the role.
🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.
The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role. Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team.
United States
United Kingdom only
Germany only