Remote HCC Coding Specialist – Risk Adjustment Expert

Highmark Health; Bastrop (LA); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an experienced HCC Coder to support Medicare Advantage, ACA and ESRD projects from a remote office. You will transform physician documentation into ICD-10 diagnoses and HCC categories, ensuring compliance with CMS guidelines and Highmark policies.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and strong attention to detail. Travel is 0-25% as needed.

Qualifications

• 3 years HCC coding and/or coding and billing
• Familiarity with CMS coding guidelines and RADV audits
• Experience using EMR systems and coding applications

Responsibilities

• Perform HCC coding on MA, ACA, and ESRD projects across models
• Adhere to CMS Guidelines and Highmark Policies for HCC decisions
• Support Regulatory Audits with chart reviews and rankings
• Participate in ad-hoc projects and process improvements
• Engage in RPM coding meetings and annual coding Summit

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

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 is seeking an experienced HCC Coder to support Medicare Advantage, ACA and ESRD projects from a remote office. You will transform physician documentation into ICD-10 diagnoses and HCC categories, ensuring compliance with CMS guidelines and Highmark policies.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and strong attention to detail. Travel is 0-25% as needed.