Remote HCC Coding Specialist - Risk Adjustment

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

Job summary

Highmark Health is seeking an experienced HCC Coder to support risk adjustment coding for MA, ACA, and ESRD projects. You will work with physicians and teams to ensure accurate ICD10 and HCC classifications while adhering to CMS guidelines and Highmark policies.

This remote, office-based role requires 3+ years of HCC coding and CPC/CRC/CCS/RHIT certifications, strong analytical skills, and proficiency in MS Office. Travel up to 25% may be required for audits and trainings.

Qualifications

• HCC coding on MA, ACA, and ESRD projects.
• Adheres to CMS Guidelines for Coding and Highmark’s Policy and Procedures.
• Supports RPM coding educational meetings and audits.

Responsibilities

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

Skills

HCC Coding

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

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

Job description

Highmark Health is seeking an experienced HCC Coder to support risk adjustment coding for MA, ACA, and ESRD projects. You will work with physicians and teams to ensure accurate ICD10 and HCC classifications while adhering to CMS guidelines and Highmark policies.

This remote, office-based role requires 3+ years of HCC coding and CPC/CRC/CCS/RHIT certifications, strong analytical skills, and proficiency in MS Office. Travel up to 25% may be required for audits and trainings.