Remote HCC Coding & Risk Adjustment Specialist

Highmark Health; Helena (MT); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an experienced HCC coder to support risk adjustment coding for Medicare Advantage and ACA programs. You will work with physicians and teams to ensure accurate ICD-10 diagnoses and HCC category capture, while adhering to CMS guidelines and RPM project requirements.

The role involves remote office-based work with potential travel up to 25% and requires 3+ years of HCC coding experience, CPC/CRC/CCS/RHIT certifications may be preferred.

Qualifications

• Minimum 3 years HCC coding and/or coding and billing experience.
• Proficient in medical coding guidelines and CMS coding rules.
• Experience with RPM coding processes and audits is a plus.

Responsibilities

• Perform HCC coding on MA, ACA, and ESRD projects, adapting to multiple models.
• Collaborate across departments to ensure coding accuracy and compliance.
• Support regulatory audits with initial chart reviews and data quality improvements.

Skills

Critical Thinking

Attention to Detail

Written Communications

Oral Presentation

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health is seeking an experienced HCC coder to support risk adjustment coding for Medicare Advantage and ACA programs. You will work with physicians and teams to ensure accurate ICD-10 diagnoses and HCC category capture, while adhering to CMS guidelines and RPM project requirements.

The role involves remote office-based work with potential travel up to 25% and requires 3+ years of HCC coding experience, CPC/CRC/CCS/RHIT certifications may be preferred.