Remote HCC Coding Specialist | Risk Adjustment & Compliance

Highmark Health; Town of King (WI); Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Health in the United States is seeking a skilled risk adjustment coder to support Medicare Advantage and ACA programs. You will apply HCC coding, ICD-10 terminology, and CMS guidelines across EMR systems to ensure accurate risk capture and compliant documentation.

This remote, office-based role collaborates with physicians, Quality, Compliance, and enterprise partners to drive accuracy, training, and continuous improvement in risk adjustment processes.

Qualifikationen

• 3 years HCC coding and/or coding and billing experience.
• Certified Professional Coder (CPC) and other coding credentials required.
• Remote office-based role with 0–25% travel, enterprise collaboration.

Aufgaben

• Performs HCC coding on MA, ACA, and ESRD projects with various models.
• Adheres to CMS guidelines and Highmark policies for coding decisions.
• Assists with regulatory audits via first coding review and chart ranking.
• Participates in RPM coding educational meetings and annual coding Summit.
• Identifies opportunities for process improvements and efficiencies.

Kenntnisse

HCC Coding

Attention to Detail

Critical Thinking

Communication Skills

MS Office Suite

Ausbildung

Associate degree in medical billing/coding

Tools

EMR Systems

Coding Applications

Jobbeschreibung

Highmark Health in the United States is seeking a skilled risk adjustment coder to support Medicare Advantage and ACA programs. You will apply HCC coding, ICD-10 terminology, and CMS guidelines across EMR systems to ensure accurate risk capture and compliant documentation.

This remote, office-based role collaborates with physicians, Quality, Compliance, and enterprise partners to drive accuracy, training, and continuous improvement in risk adjustment processes.