Remote HCC Coding Specialist – Risk Adjustment & CMS

Highmark Health; Georgia; Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health in the United States seeks a skilled HCC coder to perform coding for MA, ACA, and ESRD projects, applying CMS guidelines and RADV principles. You will work remotely from a home office, collaborating with physicians and care teams to ensure accurate risk adjustment documentation.

Certification requirements include CPC, CRC, CCS, and RHIT; 3 years of HCC coding experience; preferred associate degree.

Qualifications

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

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects across models.
• Assists with regulatory audits via first coding review.
• Participates in ad-hoc projects and suggests process improvements.
• Engages in RPM coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

Education

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health in the United States seeks a skilled HCC coder to perform coding for MA, ACA, and ESRD projects, applying CMS guidelines and RADV principles. You will work remotely from a home office, collaborating with physicians and care teams to ensure accurate risk adjustment documentation.

Certification requirements include CPC, CRC, CCS, and RHIT; 3 years of HCC coding experience; preferred associate degree.