Remote HCC Coding Specialist for Risk Adjustment

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

Job summary

Highmark Health is seeking a remote risk-adjustment coder to support Medicare Advantage, ACA, and ESRD projects. You will apply HCC coding, ICD-10 diagnoses, and CMS guidelines to ensure accurate risk capture and compliant documentation.

Working with physicians and cross-functional teams, you will influence coding accuracy, participate in RPM initiatives, and contribute to audits and process improvements in a remote office setting.

Qualifications

• 3 years HCC coding and/or coding and billing.
• Associate degree in medical billing/coding or related field preferred.

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD; flexes between models and apps.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects; provides recommendations for process improvements.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding or related field

Tools

CPC

CRC

CCS

RHIT

Job description

Highmark Health is seeking a remote risk-adjustment coder to support Medicare Advantage, ACA, and ESRD projects. You will apply HCC coding, ICD-10 diagnoses, and CMS guidelines to ensure accurate risk capture and compliant documentation.

Working with physicians and cross-functional teams, you will influence coding accuracy, participate in RPM initiatives, and contribute to audits and process improvements in a remote office setting.