HCC Coding Specialist - Remote Risk Adjustment Expert

Highmark Health; United States; Remote; USD 56,000 - 87,000; Full time

Job summary

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD risk adjustment coding from a remote office setting. You will work across CMS guidelines, analyze clinical documentation, and collaborate with physicians and interdisciplinary teams to ensure accurate ICD-10 and HCC categorization while maintaining RPM compliance.

Experience includes 3+ years in HCC coding and familiarity with audits, documentation improvement, and reporting tools within a HIPAA-compliant

Qualifications

• 3 years HCC coding and/or coding and billing experience.
• Familiar with RPM and CMS guidelines.
• Ability to work remote and manage multiple projects.

Responsibilities

• Perform HCC coding on MA, ACA, and ESRD projects.
• Adhere to CMS guidelines and Highmark policies.
• Support RPM coding and audits.
• Collaborate with physicians and cross-functional teams.

Skills

HCC coding

Critical thinking

Attention to detail

Written and verbal communication

Healthcare terminology

MS Word

MS Excel

MS Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

EMR systems

MS Office Suite

Job description

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD risk adjustment coding from a remote office setting. You will work across CMS guidelines, analyze clinical documentation, and collaborate with physicians and interdisciplinary teams to ensure accurate ICD-10 and HCC categorization while maintaining RPM compliance.

Experience includes 3+ years in HCC coding and familiarity with audits, documentation improvement, and reporting tools within a HIPAA-compliant