Job Description

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a HEDIS Coding Specialist. This role is essential in ensuring accurate coding and documentation related to healthcare quality metrics. The HEDIS Coding Specialist will improve the quality of patient care through diligent review and accurate reporting. By collaborating with healthcare providers and conducting thorough audits, the specialist will enhance compliance with regulatory standards. This position seeks candidates with expertise in medical coding and the ability to analyze complex data. If you have a passion for healthcare quality improvement, this is an opportunity to make a significant impact.

Accountabilities

• Conduct thorough reviews of medical records for accurate coding compliance.
• Identify opportunities for documentation improvement to enhance code accuracy.
• Educate healthcare providers on proper coding practices and HEDIS measures.
• Perform audits to assess coding accuracy and identify discrepancies.
• Apply risk adjustment coding knowledge for accurate diagnosis reporting.
• Analyze coding data to identify trends and opportunities for quality improvement.
• Ensure compliance with coding standards and organizational policies.
• Provide support and resources for healthcare providers regarding coding inquiries.
• Develop and deliver coding training sessions for providers and staff.
• Collaborate with various teams to support quality improvement initiatives.
• Generate reports to track coding accuracy and improvement efforts.
• Stay updated on coding guidelines and compliance requirements.

Requirements

• Bachelor’s degree in health information management, medical coding, nursing, or related field; or an Associate’s degree with relevant experience.
• Minimum 2-3 years of experience in medical coding and documentation.
• Familiarity with NCQA HEDIS measures and reporting requirements.
• Proficiency in ICD-10-CM, CPT, and HCPCS coding systems.
• Strong analytical and communication skills.
• Ability to work effectively in a remote environment.

Benefits

• Competitive compensation and benefits package.
• Annual incentive bonus plan.
• Comprehensive medical, dental, and vision insurance.
• Generous vacation and sick time accrual.
• 12 paid holidays per year.
• State Retirement (pension plan).
• 401(k) plan with employer match.
• Company-paid life and disability insurance.
• Access to wellness programs.
• Public Service Loan Forgiveness Qualifying Employer.

Why Apply Through Jobgether?

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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