Remote HCC Coding Specialist for Risk Adjustment

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

Job summary

Highmark Health is seeking an experienced HCC coder to support Medicare Advantage and ACA risk-adjusted coding remotely. You will apply HCC coding, CMS guidelines, and RADV considerations, collaborating with physicians, quality, compliance, and enterprise leadership to ensure accurate risk adjustment documentation.

Required CPC/CRC/CCS/RHIT certifications and at least 3 years of HCC coding experience; 5 years preferred. Strong attention to detail and effective communication are essential.

Qualifications

• Three years HCC coding and/or coding and billing experience.
• Associate degree in medical billing/coding preferred.
• Certifications CPC, CRC, CCS, RHIT required or in process.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Assists with regulatory audits through initial chart review and ranking.
• Participates in ad-hoc projects and process improvement initiatives.
• Engages in RPM coding education and annual coding summit.

Skills

HCC Coding

Critical Thinking

Attention to Detail

Presentation Skills

Written Communication

Communication Skills

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

MS Word & Excel

MS365 & Teams

Job description

Highmark Health is seeking an experienced HCC coder to support Medicare Advantage and ACA risk-adjusted coding remotely. You will apply HCC coding, CMS guidelines, and RADV considerations, collaborating with physicians, quality, compliance, and enterprise leadership to ensure accurate risk adjustment documentation.

Required CPC/CRC/CCS/RHIT certifications and at least 3 years of HCC coding experience; 5 years preferred. Strong attention to detail and effective communication are essential.