Remote HCC Coding Specialist (Risk Adjustment)

Highmark Health; Minneota (MN); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health seeks an experienced HCC coder to support Medicare Advantage, ACA programs, and RADV audits from a remote office-based role. You will analyze physician documentation, translate it into ICD10 diagnoses and HCC categories, and ensure compliance with CMS guidelines and Highmark policies.

The position involves collaborating with physicians, Quality, Compliance, and leadership to maintain high quality coding, participate in RPM projects, and drive process improvements.

Qualifications

• 3 years HCC coding and/or coding and billing
• CPC, CRC, CCS, RHIT certifications required
• Remote office-based work environment

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects with various models
• Adheres to CMS Guidelines and Highmark policies
• Supports RPM coding accuracy and productivity
• Assists regulatory audits via first coding review and chart ranking
• Participates in ad-hoc projects and process improvements

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

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

EMR systems

Job description

Highmark Health seeks an experienced HCC coder to support Medicare Advantage, ACA programs, and RADV audits from a remote office-based role. You will analyze physician documentation, translate it into ICD10 diagnoses and HCC categories, and ensure compliance with CMS guidelines and Highmark policies.

The position involves collaborating with physicians, Quality, Compliance, and leadership to maintain high quality coding, participate in RPM projects, and drive process improvements.