Remote HCC Coding Specialist for Risk Adjustment

Highmark Health; North Carolina; Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD risk adjustment projects. You will translate physician documentation into ICD-10 diagnoses and HCC categories, collaborating with physicians, Quality, Compliance and leadership to ensure accurate, compliant coding.

Remote office-based role requiring 3 years of HCC coding, CPC/CRC/CCS/RHIT certifications, and proficiency with MS Office tools. Travel 0–25% may be required.

Qualifikationen

• 3 years HCC coding and/or coding and billing.
• 5 years HCC coding and/or coding and billing.
• Certified Professional Coder (CPC); Certified Risk Coder (CRC); Certified Coding Specialist (CCS); Registered Health Information Technician (RHIT)

Aufgaben

• Performs HCC coding on projects for MA, ACA, and End Stage Renal Disease (ESRD).
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects per the direction of Leadership to address the needs of the department.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Kenntnisse

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Ausbildung

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Jobbeschreibung

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD risk adjustment projects. You will translate physician documentation into ICD-10 diagnoses and HCC categories, collaborating with physicians, Quality, Compliance and leadership to ensure accurate, compliant coding.

Remote office-based role requiring 3 years of HCC coding, CPC/CRC/CCS/RHIT certifications, and proficiency with MS Office tools. Travel 0–25% may be required.