Remote HCC Coding Specialist - Risk Adjustment Expert

Highmark Health; Indianapolis (IN); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Inc. is seeking a skilled HCC coder to deliver accurate risk adjustment coding for Medicare Advantage and ACA programs. You will work with physicians and teams to ensure compliant documentation and coding, supporting RPM initiatives and CMS guidelines.

The role emphasizes cross-functional collaboration, regulatory audits, and process improvements, with remote/office-based work and travel up to 25%.

Qualifications

• 3 years HCC coding and/or coding and billing.
• 5 years HCC coding and/or coding and billing (preferred).
• CPC/CRC/CCS/RHIT certifications (preferred).

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Fluctuates between Retro and Prospective models for MA/ESRD/ACA.
• Adheres to CMS guidelines and RPM policies.
• Supports regulatory audits with chart reviews.
• Collaborates with coding teams and leadership on process improvements.

Skills

Critical Thinking

Attention to Detail

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

MS Word

Excel

Outlook

PowerPoint

Microsoft Office Suite

MS365 & Teams

Job description

Highmark Inc. is seeking a skilled HCC coder to deliver accurate risk adjustment coding for Medicare Advantage and ACA programs. You will work with physicians and teams to ensure compliant documentation and coding, supporting RPM initiatives and CMS guidelines.

The role emphasizes cross-functional collaboration, regulatory audits, and process improvements, with remote/office-based work and travel up to 25%.