Remote HCC Coding Specialist, Risk Adjustment Expert

Highmark Health; Bristol (RI); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking an experienced HCC Coder to support risk adjustment coding for Medicare Advantage, ACA, and ESRD projects. The role requires proficiency in ICD-10, CMS guidelines, and RPM coding to ensure accurate documentation and compliant coding practices.

You will collaborate with physicians, Quality, Compliance, and enterprise partners to drive high-quality coding outcomes and participate in audits and process improvements.

Qualifications

• 3 years HCC coding and/or coding and billing.
• Certification CPC/CRC/CCS/RHIT preferred.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects; supports RPM coding accuracy.
• Assists with regulatory audits through initial chart review and ranking.
• Participates in ad-hoc projects and delivers process improvement recommendations.
• Engages in RPM coding trainings and annual coding Summit.

Skills

HCC Coding

Attention to Detail

Written Communications

Communication Skills

Critical Thinking

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health is seeking an experienced HCC Coder to support risk adjustment coding for Medicare Advantage, ACA, and ESRD projects. The role requires proficiency in ICD-10, CMS guidelines, and RPM coding to ensure accurate documentation and compliant coding practices.

You will collaborate with physicians, Quality, Compliance, and enterprise partners to drive high-quality coding outcomes and participate in audits and process improvements.