Remote HCC Coding Specialist – Risk Adjustment Expert

Highmark Health; East Honolulu (HI); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health in the United States is seeking an HCC coder for remote office-based work supporting Medicare Advantage and ACA risk adjustment coding. You will translate physician documentation into ICD-10 diagnoses and HCC categories, guided by CMS rules and RADV audits, collaborating with Quality, Compliance and Enterprise leadership.

The role requires CPC/CRC/CCS/RHIT credentials, 3+ years of HCC coding, and strong attention to detail.

Qualifications

• 3 years HCC coding and/or coding and billing
• 3+ years experience in MA/ACA risk adjustment coding preferred
• Familiarity with CMS guidelines and RADV audits
• Remote office-based role with 0–25% travel

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects across models
• Supports regulatory audits with initial chart review and ranking
• Collaborates with physicians, Quality, Compliance, and Enterprise leadership
• Engages in RPM coding education and annual coding Summit
• Assists with process improvements and ad-hoc projects

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, health insurance, healthcare or related field

Certified Professional Coder (CPC)

Certified Risk Coder (CRC)

Certified Coding Specialist (CCS)

Registered Health Information Technician (RHIT)

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health in the United States is seeking an HCC coder for remote office-based work supporting Medicare Advantage and ACA risk adjustment coding. You will translate physician documentation into ICD-10 diagnoses and HCC categories, guided by CMS rules and RADV audits, collaborating with Quality, Compliance and Enterprise leadership.

The role requires CPC/CRC/CCS/RHIT credentials, 3+ years of HCC coding, and strong attention to detail.