Remote HCC Coding Specialist - Risk Adjustment

Highmark Health; Santa Fe (NM); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Inc. is seeking an experienced HCC Coder to support risk adjustment coding for MA, ACA, and ESRD projects.

You will work across multiple coding models in various EHR and coding applications, ensuring accuracy and compliance with CMS guidelines and company policies. The role emphasizes collaboration with physicians, Quality, Compliance, and enterprise leadership, plus participation in RPM coding education and audits.

Qualifications

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

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Flexes between coding models and projects.
• Adheres to CMS guidelines and company policies.
• Maintains RPM coding accuracy and productivity.
• Assists with regulatory audits via first coding review.
• Builds partnerships within coding teams and internal partners.
• Participates in ad-hoc projects and recommends process improvements.
• Engages in RPM coding educational meetings.
• Other duties as assigned.

Skills

HCC Coding

Critical Thinking

Attention to Detail

Written Communications

Written and Oral Presentation Skills

Communication Skills

MS Office Suite

Education

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

Tools

MS Word, Excel, Outlook, PowerPoint

Job description

Highmark Inc. is seeking an experienced HCC Coder to support risk adjustment coding for MA, ACA, and ESRD projects.

You will work across multiple coding models in various EHR and coding applications, ensuring accuracy and compliance with CMS guidelines and company policies. The role emphasizes collaboration with physicians, Quality, Compliance, and enterprise leadership, plus participation in RPM coding education and audits.