Remote HCC Coding & Risk Adjustment Specialist

Highmark Health; East Honolulu (HI); Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Health is seeking an experienced HCC Coder to support risk adjustment coding for MA, ACA, and ESRD programs. You will work with physicians and care teams to ensure accurate ICD-10 and HCC classifications, while adhering to CMS guidelines and RPM requirements.

The role involves collaborating on audits, educational sessions, and process improvements to drive quality and compliance in coding activities across diverse health plan projects.

Qualifikationen

• 3 years HCC coding and/or coding and billing experience required.
• 5 years HCC coding and/or coding and billing preferred.
• Industry credentials CPC, CRC, CCS, RHIT strongly preferred.

Aufgaben

• Performs HCC coding on MA, ACA, and ESRD projects across multiple models and systems.
• Supports regulatory audits with chart review and ranking of codes.
• Participates in ad-hoc projects and process-improvement initiatives.
• Engages in RPM coding education and annual coding summits.

Kenntnisse

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Ausbildung

Associate degree in medical billing/coding, health insurance, healthcare or related field

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Jobbeschreibung

Highmark Health is seeking an experienced HCC Coder to support risk adjustment coding for MA, ACA, and ESRD programs. You will work with physicians and care teams to ensure accurate ICD-10 and HCC classifications, while adhering to CMS guidelines and RPM requirements.

The role involves collaborating on audits, educational sessions, and process improvements to drive quality and compliance in coding activities across diverse health plan projects.