Remote HCC Coding Specialist - Risk Adjustment Expert

Highmark Health; Accident (AR); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an experienced HCC coding professional for remote work, focusing on Risk Adjustment in MA, ACA, and ESRD programs. You will analyze physician documentation, translate into ICD-10 diagnoses and HCC categories, and support audits and education initiatives.

The role requires CPC/CRC/CCS/RHIT certifications and 3 years of HCC coding experience, with opportunities to participate in RPM projects and process improvements. Remote position with some travel.

Qualifications

• 3 years HCC coding and/or coding and billing
• Certified Professional Coder (CPC)
• Certified Risk C coder (CRC)
• Certified Coding Specialist (CCS)
• RHIT – Registered Health Information Technician
• 5 years HCC coding and/or coding and billing (preferred)

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD.
• Adheres to CMS Guidelines for Coding and Highmark’s Policy and Procedures.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Build partnerships with coding teams and internal partners.
• Participates on ad-hoc projects and suggests process improvements.
• Engages in RPM Coding educational meetings and annual coding Summit.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation

Written Communications

Communication Skills

HCC Coding

MS Word

MS Excel

MS Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

EMR systems

Coding applications

Job description

Highmark Health is seeking an experienced HCC coding professional for remote work, focusing on Risk Adjustment in MA, ACA, and ESRD programs. You will analyze physician documentation, translate into ICD-10 diagnoses and HCC categories, and support audits and education initiatives.

The role requires CPC/CRC/CCS/RHIT certifications and 3 years of HCC coding experience, with opportunities to participate in RPM projects and process improvements. Remote position with some travel.