Remote HCC Coding Specialist for Risk Adjustment

Highmark Health; East Windsor Hill (CT); Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Health is seeking an experienced HCC/Coding Specialist to deliver accurate risk adjustment coding for Medicare Advantage, ACA, and ESRD projects. You will work across various models using CMS guidelines and internal policies to ensure compliance and quality.

You will collaborate with physicians, QA, and leadership to improve documentation, participate in RPM projects, and support audits. Remote-office based role with travel up to 25% as needed.

Qualifikationen

• 3 years HCC coding and/or coding and billing.
• Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), RHIT are preferred.
• Experience in regulatory audits and RPM coding education is a plus.

Aufgaben

• Performs HCC coding on MA, ACA, and ESRD projects across multiple models.
• Supports Regulatory Audits with first coding review and chart ranking.
• Participates in ad-hoc projects to improve processes and efficiency.
• Engages in RPM coding education sessions and annual coding Summit.

Kenntnisse

Critical Thinking

Attention to Detail

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Ausbildung

Associate degree in medical billing/coding

Tools

EMR systems

CMS Guidelines

Jobbeschreibung

Highmark Health is seeking an experienced HCC/Coding Specialist to deliver accurate risk adjustment coding for Medicare Advantage, ACA, and ESRD projects. You will work across various models using CMS guidelines and internal policies to ensure compliance and quality.

You will collaborate with physicians, QA, and leadership to improve documentation, participate in RPM projects, and support audits. Remote-office based role with travel up to 25% as needed.