Remote HCC Coding Specialist for Risk Adjustment

Highmark Health; Central City (NE); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an experienced HCC coder to support Medicare Advantage, ACA, and ESRD risk adjustment initiatives. You will apply coding, clinical terminology, and CMS guidelines to optimize documentation and accurately classify ICD-10 and HCCs.

The role collaborates with physicians, Compliance, Quality, and Leadership to drive quality and compliance. The position enables remote work and emphasizes RPM projects, audits, and continuous process improvement while ensuring HIPAA

Qualifications

• 3 years HCC coding and/or coding and billing experience.
• Experience with MA, ACA, ESRD HCC models preferred.
• Familiarity with CMS guidelines and HIPAA compliance.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects, adapting to multiple models.
• Supports regulatory audits with initial chart review and ranking.
• Participates in ad-hoc projects and process improvement efforts.
• Engages in RPM coding education and annual coding summits.
• Adheres to CMS guidelines and Highmark policies.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Certified Professional Coder (CPC)

Certified Risk Coder (CRC)

Certified Coding Specialist (CCS)

Registered Health Information Technician (RHIT)

Job description

Highmark Health is seeking an experienced HCC coder to support Medicare Advantage, ACA, and ESRD risk adjustment initiatives. You will apply coding, clinical terminology, and CMS guidelines to optimize documentation and accurately classify ICD-10 and HCCs.

The role collaborates with physicians, Compliance, Quality, and Leadership to drive quality and compliance. The position enables remote work and emphasizes RPM projects, audits, and continuous process improvement while ensuring HIPAA