Remote HCC Coding Specialist: Risk Adjustment

Highmark Health; Texas; A distancia; USD 37.000 - 58.000; Jornada completa

Descripción de la vacante

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will perform diverse HCC coding, interpret physician documentation to ICD-10 diagnoses and HCC categories, and help ensure CMS-compliant coding across RPM initiatives.

Collaborating with physicians, Quality, Compliance, and leadership, you will drive accurate risk-adjustment coding, participate in audits, and contribute to process improvements in a remote, office-based setting.

Formación

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing (preferred)
• Proficient with CMS Guidelines for Coding and Highmark policies

Responsabilidades

• Performs HCC coding on projects for MA, ACA, and ESRD; works independently across models and EMR systems.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects to address department needs and provide process improvement recommendations.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Conocimientos

Critical Thinking

Attention to Detail

Written & Oral Presentation

Written Communications

Communication Skills

HCC Coding

Educación

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

Certified Professional Coder (CPC)

Certified Risk Coder (CRC)

Certified Coding Specialist (CCS)

Registered Health Information Technician (RHIT)

Herramientas

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Descripción del empleo

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will perform diverse HCC coding, interpret physician documentation to ICD-10 diagnoses and HCC categories, and help ensure CMS-compliant coding across RPM initiatives.

Collaborating with physicians, Quality, Compliance, and leadership, you will drive accurate risk-adjustment coding, participate in audits, and contribute to process improvements in a remote, office-based setting.