Remote HCC Coding Specialist: Risk Adjustment Expert

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

Job summary

Highmark Inc. is seeking a Risk Adjustment Coder to deliver accurate HCC coding for MA, ACA, and ESRD programs. You will translate physician documentation into ICD-10 diagnoses and HCC categories, collaborating with physicians, Quality, Compliance, and leadership to ensure high quality coding and RPM project success.

This role requires at least 3 years of HCC coding and billing experience (5 years preferred). Certifications such as CPC, CRC, CCS, or RHIT are valued.

Qualifications

• Minimum 3 years HCC coding and/or coding and billing experience.
• Preferred 5 years HCC coding and/or coding and billing.
• Certifications such as CPC/CRC/CCS/RHIT preferred.
• Preferred Associate degree in medical billing/coding or related field.
• Proficiency with MS Word, Excel, Outlook, PowerPoint and MS365/Teams.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Works across coding applications and EMR systems.
• Adheres to CMS Guidelines and Highmark’s policies.
• Supports RPM coding audits and reviews.
• Identifies process improvements and participates in ad-hoc projects.
• Engages in RPM coding educational meetings.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding or related field

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Inc. is seeking a Risk Adjustment Coder to deliver accurate HCC coding for MA, ACA, and ESRD programs. You will translate physician documentation into ICD-10 diagnoses and HCC categories, collaborating with physicians, Quality, Compliance, and leadership to ensure high quality coding and RPM project success.

This role requires at least 3 years of HCC coding and billing experience (5 years preferred). Certifications such as CPC, CRC, CCS, or RHIT are valued.