Remote HCC Coding Specialist - Risk Adjustment Expert

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

Job summary

Highmark Health is seeking a skilled HCC Coder to support risk adjustment coding for MA, ACA, and ESRD programs. You will apply CMS guidelines, work across multiple models, and collaborate with physicians and cross-functional teams to maintain accurate documentation and coding quality.

The role includes participating in RPM coding initiatives and contributing to audits, education, and process improvements. Remote options are available across the Health Plan network.

Qualifications

• 3 years HCC coding and/or coding and billing experience.
• 5 years HCC coding and/or coding and billing experience preferred.
• Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects and flexes between models.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects and provides process-improvement recommendations.
• Engages in RPM Coding educational meetings and annual coding Summit.

Skills

Critical Thinking

Attention to Detail

Written and Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

MS Excel

MS Outlook

PowerPoint

MS365 & Teams

Education

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

Job description

Highmark Health is seeking a skilled HCC Coder to support risk adjustment coding for MA, ACA, and ESRD programs. You will apply CMS guidelines, work across multiple models, and collaborate with physicians and cross-functional teams to maintain accurate documentation and coding quality.

The role includes participating in RPM coding initiatives and contributing to audits, education, and process improvements. Remote options are available across the Health Plan network.