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HCC Coding Specialist

HCC Coding Specialist

SynapticureWashington, DC, US
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HCC Coding Specialist

As a patient and caregiver-founded company, Synapticure provides instant access to expert neurologists, cutting-edge treatments and trials, and wraparound care coordination and behavioral health support in all 50 states through a virtual care platform. Partnering with providers and health plans, including CMS' new GUIDE dementia care model, Synapticure is dedicated to transforming the lives of millions of individuals and their families living with neurodegenerative diseases like Alzheimer's, Parkinson's, and ALS.

Job Duties What Youll Be Doing

  • Review neurology, behavioral health, and psychiatry patient medical records, including physician notes, hospital records, and clinical documentation
  • Accurately assign ICD-10-CM codes based on documentation, following HCC coding and CMS risk adjustment guidelines
  • Assign appropriate CPT, HCPCS, and ICD-10-CM codes for encounter-based services to ensure complete, compliant claims
  • Identify documentation deficiencies impacting HCC assignment and collaborate with providers to improve specificity
  • Query providers for clarification when documentation is incomplete, ambiguous, or contradictory
  • Ensure compliance with coding standards, payer requirements, and organizational policies
  • Participate in coding audits and quality reviews, providing feedback and education to providers and peers
  • Collaborate with CDI specialists, auditors, and revenue cycle teams to optimize documentation and coding processes
  • Maintain productivity and accuracy benchmarks
  • Stay current on updates to coding rules, HCC guidelines, and mental / neurological health regulations

Requirements What We Look For In You

  • High school diploma or equivalent required; Associate's or Bachelor's degree in Health Information Management, Nursing, or related field preferred
  • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required
  • Certified Risk Adjustment Coder (CRC) or Certified Documentation Improvement Practitioner (CDIP) strongly preferred
  • 23 years of experience in medical coding, with at least 12 years in HCC coding and risk adjustment
  • Expert knowledge of ICD-10-CM coding guidelines and HCC risk adjustment models
  • Strong understanding of medical terminology, anatomy, physiology, and pharmacology
  • Excellent analytical and problem-solving skills with the ability to interpret complex medical records
  • Strong attention to detail and accuracy
  • Exceptional written and verbal communication skills for provider collaboration and education
  • Proficiency with EHR systems, coding software, and computer applications
  • Ability to work independently and collaboratively in a fast-paced environment

    • Preferred Qualifications

  • Experience with multiple payer risk adjustment methodologies
  • Knowledge of CPT and HCPCS coding
  • Experience in a large healthcare system, managed care organization, or telehealth environment

    • Our Values

  • Relentless focus on patients and caregivers. We are determined to provide an exceptional experience for every patient we have the privilege to serve, and we put our patients first in everything we do.
  • Embody the spirit and humanity of those living with neurodegenerative disease. Inspired by our founders, families, and personal experiences, we recognize the seriousness of our patients' circumstances and meet that challenge every day with empathy, compassion, kindness, joy, and most importantly with hope.
  • Seek to understand, and stay curious. We start by listening to one another, our partners, our patients, and their caregivers. We communicate with authenticity and humility, prioritizing honesty and directness while recognizing we always have something to learn.
  • Embrace the opportunity. We are energized by the importance of our mission and bias toward action.

    • Competitive salary based on experience

    Comprehensive medical, dental, and vision coverage

    401(k) plan with employer matching

    Remote-first work environment with home office stipend

    Generous paid time off and sick leave

    Professional development and continuing education support

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    Coding Specialist • Washington, DC, US