Remote HCC Coding Specialist for Risk Adjustment

Highmark Health; Clayton (NM); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking a skilled HCC coder for remote, office-based work. You will perform HCC coding on MA, ACA, and ESRD projects, ensure CMS guideline compliance, and support RPM coding initiatives. Remote flexibility and 0–25% travel are involved.

Ideal candidates hold CPC, CRC, CCS, and RHIT certifications with 3 years of HCC coding experience; associate degree preferred. Collaborate with physicians, Quality, Compliance and enterprise leadership to drive accurate risk adjustment coding.

Qualifications

• CPC/CRC/CCS/RHIT certifications required.
• 3 years HCC coding and/or coding and billing experience.
• Experience with CMS guidelines and RADV audits preferred.
• Remote office-based role with travel up to 25%.

Responsibilities

• Perform HCC coding for MA, ACA, and ESRD projects.
• Support regulatory audits with chart review and ranking.
• Participate in ad-hoc projects and process improvements.
• Engage in RPM coding education and annual coding summit.
• Adhere to CMS guidelines and company policy.

Skills

Critical Thinking

Attention to Detail

Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Office Suite

Job description

Highmark Health is seeking a skilled HCC coder for remote, office-based work. You will perform HCC coding on MA, ACA, and ESRD projects, ensure CMS guideline compliance, and support RPM coding initiatives. Remote flexibility and 0–25% travel are involved.

Ideal candidates hold CPC, CRC, CCS, and RHIT certifications with 3 years of HCC coding experience; associate degree preferred. Collaborate with physicians, Quality, Compliance and enterprise leadership to drive accurate risk adjustment coding.