Remote HCC Coding Specialist – Risk Adjustment Expert

Highmark Health; Central City (KY); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health seeks an experienced HCC Coder to perform coding for MA, ACA, and ESRD projects, using CMS guidelines and RPM requirements. You will collaborate with physicians and teams to ensure accurate risk adjustment coding and compliance with HIPAA and security policies.

Required CPC-CRC-CCS-RHIT certifications, 3 years HCC coding/billing, and an Associate degree (preferred). Remote office-based role with 0–25% travel; pay range $27.02–$41.85 per hour.

Qualifications

• 3 years HCC coding and/or coding and billing
• Associate degree in medical billing/coding, health insurance, healthcare or related field preferred
• CPC, CRC, CCS, RHIT certifications required or preferred

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD; flexes between coding projects with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and EMR systems
• Assists with Regulatory Audits by performing first coding review and ranking of charts; builds partnerships within coding teams and internal partners
• Participates on ad-hoc projects per Leadership direction to address department needs; provides recommendations for process improvements and efficiencies
• Engages in RPM Coding educational meetings and annual coding Summit
• Other duties as assigned

Skills

HCC Coding

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

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 seeks an experienced HCC Coder to perform coding for MA, ACA, and ESRD projects, using CMS guidelines and RPM requirements. You will collaborate with physicians and teams to ensure accurate risk adjustment coding and compliance with HIPAA and security policies.

Required CPC-CRC-CCS-RHIT certifications, 3 years HCC coding/billing, and an Associate degree (preferred). Remote office-based role with 0–25% travel; pay range $27.02–$41.85 per hour.