Remote HCC Coding Specialist – Medicare/ACA Risk Adjustment

Highmark Health; Columbia (SC); Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Inc. seeks a skilled HCC Coder to support risk adjustment coding for MA and ACA programs, interpreting physician documentation into ICD-10 and HCC categories. The role collaborates with physicians, Quality, Compliance, and leadership to ensure accurate, compliant coding.

The position emphasizes collaboration across coding teams, involvement in audits, and participation in RPM initiatives to improve documentation and data quality.

Qualifikationen

• 3 years HCC coding and/or coding and billing experience required.
• Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.

Aufgaben

• Performs HCC coding on MA, ACA, and ESRD projects.
• Works independently across coding apps and EMR systems.
• Adheres to CMS guidelines and Highmark policies for HCC coding.
• Maintains RPM coding accuracy and productivity.
• Supports audits with initial chart reviews and ranking.
• Collaborates with coding teams and internal partners.
• Participates in ad-hoc projects and process improvement initiatives.
• Engages in RPM coding training and coding summits.

Kenntnisse

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Travel

Ausbildung

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

EMR/EHR systems

Jobbeschreibung

Highmark Inc. seeks a skilled HCC Coder to support risk adjustment coding for MA and ACA programs, interpreting physician documentation into ICD-10 and HCC categories. The role collaborates with physicians, Quality, Compliance, and leadership to ensure accurate, compliant coding.

The position emphasizes collaboration across coding teams, involvement in audits, and participation in RPM initiatives to improve documentation and data quality.