Remote HCC Coding Specialist for Risk Adjustment

Highmark Health; New Mexico; Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an experienced HCC coder to deliver accurate risk adjustment coding for MA/ACA programs. You will work with physicians and teams to ensure compliant documentation and coding, supporting RPM projects and audits.

Required CPC/CRC/CCS/RHIT credentials with 3+ years of HCC coding experience. This remote, office-based role offers growth in a CMS-regulated environment with opportunities for education and process improvements.

Qualifications

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing (preferred)
• HCC coding knowledge and CMS guidelines relevant to MA/ACA
• Experience with RPM coding and audits, data validation and documentation improvement

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects; flexible across Retro and Prospective models
• Works in various coding applications and EMR systems; adheres to CMS guidelines and Highmark policies
• Supports regulatory audits through initial chart reviews and collaboration with coding teams
• Participates in ad-hoc projects and leadership-directed process improvements
• Engages in RPM coding education and annual coding Summit

Skills

Critical Thinking

Attention to Detail

Presentation skills

Written communication

Verbal communication

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Certified Professional Coder (CPC)

Certified Risk Coder (CRC)

Certified Coding Specialist (CCS)

Registered Health Information Technician (RHIT)

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

Job description

Highmark Health is seeking an experienced HCC coder to deliver accurate risk adjustment coding for MA/ACA programs. You will work with physicians and teams to ensure compliant documentation and coding, supporting RPM projects and audits.

Required CPC/CRC/CCS/RHIT credentials with 3+ years of HCC coding experience. This remote, office-based role offers growth in a CMS-regulated environment with opportunities for education and process improvements.