Remote HCC Coding Specialist for MA/ACA

Highmark Health; Beryl (WV); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an HCC coder to deliver accurate risk adjustment coding for MA/ACA programs, collaborating with physicians and care teams. Primary tasks include coding, audits, and education to improve documentation and RPM compliance.

The role emphasizes CMS guidelines, accuracy, and cross-functional partnership, with remote office-based work and travel up to 25% as needed. Certifications such as CPC/CRC/CCS/RHIT preferred and 3+ years of experience required.

Qualifications

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing
• Knowledge of CMS Guidelines for Coding and RPM requirements

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD across multiple models and systems.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects to address department needs and improve processes.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

HCC Coding

Critical Thinking

Attention to Detail

Written Communications

Communication Skills

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 HCC coder to deliver accurate risk adjustment coding for MA/ACA programs, collaborating with physicians and care teams. Primary tasks include coding, audits, and education to improve documentation and RPM compliance.

The role emphasizes CMS guidelines, accuracy, and cross-functional partnership, with remote office-based work and travel up to 25% as needed. Certifications such as CPC/CRC/CCS/RHIT preferred and 3+ years of experience required.