Remote HCC Coding Specialist - Risk Adjustment

Highmark Health

Williamstown (NJ)

Remote

USD 37,000 - 58,000

Full time

5 days ago

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Job summary

Highmark Health is seeking a skilled HCC Coder to support risk adjustment programs for MA and ACA beneficiaries. You will perform HCC coding across MA, ACA, ESRD, and contribute to documentation improvement while adhering to CMS guidelines and Highmark policies.

This remote/off-site role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and strong attention to detail. Collaboration with clinicians and analytics teams is essential to drive accurate coding and RPM project

Qualifications

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

Responsibilities

Performs HCC coding on projects for MA, ACA, and ESRD. Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for Coding and Highmark’s Policy and Procedures to guide HCC coding decision making. Maintains RPM coding accuracy and productivity requirements.
Assists with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work within coding teams and internal partners critical to HCC coding.
Participates on ad-hoc projects per the direction of Leadership to address the needs of the department. Provides recommendations for process improvements and efficiencies.
Engages in RPM Coding educational meetings and annual coding Summit.
Other duties as assigned.