HCC Coding Specialist | Risk Adjustment Expert (Remote)

Highmark Health; Massachusetts; Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking a skilled HCC coder to perform and manage coding across Medicare Advantage, ACA, and ESRD programs. You will work remotely, applying CMS guidelines and high accuracy standards to support quality risk adjustment and RPM initiatives.

The role requires 3 years of HCC coding experience and CPC/CRC/CCS/RHIT certifications, with preferred Associate degree in medical billing/coding. Join a collaborative team focused on compliant documentation and education.

Qualifications

• 3 years HCC coding and/or coding and billing.
• Must hold CPC, CRC, CCS, RHIT certifications.
• Remote/office-based role with adherence to CMS guidelines and Highmark policy.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects, flexing across models.
• Assists with Regulatory Audits through initial chart coding reviews.
• Participates in ad-hoc projects and suggests process improvements.
• Engages in RPM coding education and annual coding Summit.
• Other duties as assigned.

Skills

HCC Coding

Critical Thinking

Attention to Detail

Written Communication

Presentation Skills

Communication Skills

MS Word

MS Excel

MS Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

None

Job description

Highmark Health is seeking a skilled HCC coder to perform and manage coding across Medicare Advantage, ACA, and ESRD programs. You will work remotely, applying CMS guidelines and high accuracy standards to support quality risk adjustment and RPM initiatives.

The role requires 3 years of HCC coding experience and CPC/CRC/CCS/RHIT certifications, with preferred Associate degree in medical billing/coding. Join a collaborative team focused on compliant documentation and education.