Remote HCC Coding Specialist – Risk Adjustment

Highmark Health; Washington (NC); On-site; USD 60,000 - 80,000; Full time

Job summary

Highmark Health is looking for a Hierarchical Condition Category (HCC) Coding Specialist to deliver value to healthcare plans and beneficiaries. The role requires expertise in HCC coding, clinical terminology, and adherence to CMS guidelines.

The successful candidate will support various coding projects and assist with audits, while working collaboratively with teams to ensure compliance and accuracy. Preferred qualifications include an associate degree related to healthcare and relevant certifications. This position is remote, providing flexibility in location.

Qualifications

• 3 years of HCC coding and/or coding and billing experience required.
• Certified Professional Coder (CPC), Certified Risk Coder (CRC), or equivalent certification required.
• Strong proficiency in MS Word, Excel, Outlook, and PowerPoint.

Responsibilities

• Perform HCC coding for various projects including MA, ACA, and ESRD.
• Assist with Regulatory Audits by performing coding reviews.
• Engage in RPM Coding educational meetings and recommended coding practices.

Skills

Hierarchical Condition Category (HCC) Coding

Critical Thinking

Attention to Detail

Communication Skills

Microsoft Office Suite

Education

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

Job description

Highmark Health is looking for a Hierarchical Condition Category (HCC) Coding Specialist to deliver value to healthcare plans and beneficiaries. The role requires expertise in HCC coding, clinical terminology, and adherence to CMS guidelines.

The successful candidate will support various coding projects and assist with audits, while working collaboratively with teams to ensure compliance and accuracy. Preferred qualifications include an associate degree related to healthcare and relevant certifications. This position is remote, providing flexibility in location.