- Highmark Health (Boston, MA)
- …government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA) through Hierarchical Condition Category ( HCC ) coding, medical coding, ... by analyzing physician documentation and interpreting into ICD-10 diagnoses and HCC disease categories. Supports other key objectives to drive capture of… more
- Commonwealth Care Alliance (Boston, MA)
- …leadership, and strategically and operationally leads various quality reviews of claims, Hierarchical Condition Categories ( HCC ) and clinical coding, call ... pre-payment and post-payment claim reviews, call monitoring reviews, and evaluation of HCC audits/reviews, among others, to relevant departments. The role also leads… more
- Commonwealth Care Alliance (Boston, MA)
- …and is responsible for designing quality and control assurance reviews of claims, Hierarchical Condition Categories ( HCC ) and clinical coding, call ... of relevant quality audit/review results, call monitoring reviews, and evaluation of HCC audits/reviews, among others, to relevant departments. The role also leads… more