Remote HCC Coding Specialist – Risk Adjustment Expert

Highmark Health; Heber (UT); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking a Remote Health Information Coder to support risk adjustment coding for MA, ACA, and ESRD programs. You will analyze physician documentation and translate it into ICD-10 diagnoses and HCC categories, while ensuring CMS guidelines and RPM requirements are met.

Collaborating with physicians, Quality, Compliance and enterprise partners, you will participate in audits, education sessions, and process improvements to improve coding accuracy and productivity in a remote

Qualifications

• 3 years HCC coding and/or coding and billing.
• Experience with MA, ACA, and ESRD coding models is preferred.
• Knowledge of CMS guidelines and RPM requirements.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects across models.
• Assists with regulatory audits by performing initial chart reviews.
• Participates in ad-hoc projects and process improvements.
• Engages in RPM coding education meetings and coding summits.

Skills

HCC Coding

Attention to Detail

Critical Thinking

Written Communications

Communication Skills

Presentation Skills

MS Word

MS Excel

MS Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding, health insurance, healthcare or related field

Tools

EMR systems

Job description

Highmark Health is seeking a Remote Health Information Coder to support risk adjustment coding for MA, ACA, and ESRD programs. You will analyze physician documentation and translate it into ICD-10 diagnoses and HCC categories, while ensuring CMS guidelines and RPM requirements are met.

Collaborating with physicians, Quality, Compliance and enterprise partners, you will participate in audits, education sessions, and process improvements to improve coding accuracy and productivity in a remote