Remote HCC Coding Specialist - Risk Adjustment Expert

Highmark Health; Florida; Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health in the United States is seeking an experienced HCC coder to deliver accurate risk adjustment coding for MA, ACA, and ESRD programs. You will interpret clinical documentation into ICD-10 and HCC categories, work with physicians and teams, and support RPM initiatives to ensure CMS compliance and high-quality data.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and the ability to work remote with occasional travel.

Qualifications

• 3 years HCC coding and/or coding and billing.
• Familiarity with CMS Guidelines and risk adjustment.
• Experience with regulatory audits and chart reviews.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Adheres to CMS Guidelines and Highmark policies.
• Assists with regulatory audits and chart reviews.
• Supports RPM coding projects and educational activities.

Skills

HCC Coding

Attention to Detail

Critical Thinking

Written Communications

Communication Skills

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

EMR systems

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health in the United States is seeking an experienced HCC coder to deliver accurate risk adjustment coding for MA, ACA, and ESRD programs. You will interpret clinical documentation into ICD-10 and HCC categories, work with physicians and teams, and support RPM initiatives to ensure CMS compliance and high-quality data.

The role requires 3 years of HCC coding experience, CPC/CRC/CCS/RHIT certifications, and the ability to work remote with occasional travel.