Remote HCC Coding Specialist (Risk Adjustment)

Highmark Health; Beryl (WV); Teletrabalho; USD 37 000 - 58 000; Tempo integral

Resumo da oferta

Highmark Health seeks an experienced HCC coder to deliver accurate risk adjustment coding for Medicare Advantage, ACA, and ESRD projects from a remote office setting. You will interpret physician documentation into ICD-10 diagnoses and HCC categories, while aligning with CMS guidelines and Highmark policies.

Responsibilities include supporting RPM risk adjustment projects, participating in audits, and driving process improvements.

Qualificações

• 3 years HCC coding and/or coding and billing
• Certified CPC, CRC, CCS, RHIT certifications
• Associate degree in medical billing/coding preferred
• Remote office-based role with 0–25% travel

Responsabilidades

• Performs HCC coding on MA, ACA, and ESRD projects with various models.
• Assist with regulatory audits via first coding review and chart ranking.
• Participate in ad-hoc projects and recommend process improvements.
• Engage in RPM coding education meetings and annual coding Summit.
• Adhere to CMS guidelines and Highmark policies.

Conhecimentos

HCC Coding

Critical Thinking

Attention to Detail

Written Communications

Presentation Skills

Communication Skills

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Office Suite

Formação académica

Associate degree in medical billing/coding

Descrição da oferta de emprego

Highmark Health seeks an experienced HCC coder to deliver accurate risk adjustment coding for Medicare Advantage, ACA, and ESRD projects from a remote office setting. You will interpret physician documentation into ICD-10 diagnoses and HCC categories, while aligning with CMS guidelines and Highmark policies.

Responsibilities include supporting RPM risk adjustment projects, participating in audits, and driving process improvements.