Remote HCC Coding & Risk Adjustment Specialist

Highmark Health; Eagle (ID); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an experienced HCC/Coding Specialist to support Medicare Advantage and ACA risk adjustment coding from a remote office. You will ensure accurate ICD-10/HCC coding, align with CMS guidelines, and support RPM initiatives while collaborating with physicians, Quality, Compliance, and Enterprise teams.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and proficiency with MS Office and reporting tools.

Qualifications

• 3 years HCC coding and/or coding and billing
• Certification CPC/CRC/CCS/RHIT preferred or required

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects, including Retro and Prospective models.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects per Leadership guidance to improve processes.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Presentation skills

Written Communication

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree (preferred)

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health is seeking an experienced HCC/Coding Specialist to support Medicare Advantage and ACA risk adjustment coding from a remote office. You will ensure accurate ICD-10/HCC coding, align with CMS guidelines, and support RPM initiatives while collaborating with physicians, Quality, Compliance, and Enterprise teams.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and proficiency with MS Office and reporting tools.