Remote HCC Coding Specialist – Medical Billing & Risk Adjustment

Highmark Health; Springfield (IL); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Inc. in Springfield, IL is seeking a skilled HCC Coder to support risk adjustment coding for MA, ACA, and ESRD programs, ensuring accurate ICD-10 diagnoses and HCC categorization.

You will work across coding projects and EMR systems, adhere to CMS guidelines and company policies, and contribute to RPM coding and regulatory audits.

Preferred candidates have 3+ years of HCC coding and hold CPC, CRC, CCS, or RHIT, with a strong emphasis on detail and communication.

Qualifications

• Proficient HCC coding knowledge and CMS guidelines.
• Strong written and oral presentation and communication skills.
• Proficiency with Microsoft Office (Word/Excel/Outlook/PowerPoint/MS365).

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Flex between coding projects and EMR systems to support goals.
• Adheres to CMS Guidelines and Highmark policies for coding decisions.
• Maintains RPM coding accuracy and supports regulatory audits.
• Provides recommendations for process improvements and efficiencies.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Inc. in Springfield, IL is seeking a skilled HCC Coder to support risk adjustment coding for MA, ACA, and ESRD programs, ensuring accurate ICD-10 diagnoses and HCC categorization.

You will work across coding projects and EMR systems, adhere to CMS guidelines and company policies, and contribute to RPM coding and regulatory audits.

Preferred candidates have 3+ years of HCC coding and hold CPC, CRC, CCS, or RHIT, with a strong emphasis on detail and communication.