Remote HCC Coding Specialist - Risk Adjustment

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

Job summary

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will apply ICD-10 and HCC models across multiple EMR systems, ensuring CMS-compliant coding accuracy and RPM program support.

The role emphasizes collaboration with physicians, Quality, Compliance, and enterprise partners to drive accurate risk adjustment and documentation improvement. Remote/office-based work options may apply.

Qualifications

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD. Flexes between coding projects with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and EMR systems to support departmental goals.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects per the direction of Leadership to address department needs and identify process improvements.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Communication Skills

HCC Coding

MS Office Suite

Education

Associate degree in medical billing/coding

RHIT

CRC

CPC

CCS

Tools

MS Word/Excel/Outlook/PowerPoint

MS365 & Teams

Job description

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will apply ICD-10 and HCC models across multiple EMR systems, ensuring CMS-compliant coding accuracy and RPM program support.

The role emphasizes collaboration with physicians, Quality, Compliance, and enterprise partners to drive accurate risk adjustment and documentation improvement. Remote/office-based work options may apply.