Remote HCC Coding Specialist | Risk Adjustment Expert

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

Job summary

Highmark Health is seeking a skilled HCC coder to support risk adjustment coding for MA, ACA, and ESRD programs. The role requires independent work across multiple coding systems, adherence to CMS guidelines, and collaboration with physicians and teams to ensure accurate documentation and compliant coding.

Responsibilities include supporting RPM projects, audits, and process improvements, while promoting high quality outcomes. Position is remote/office-based with travel up to 25% as needed.

Qualifications

• 3 years HCC coding and/or coding and billing.
• 5 years HCC coding and/or coding and billing (preferred).
• Certification in CPC, CRC, CCS, RHIT (required or preferred).
• Remote Office-based work environment understanding and HIPAA compliance.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects with various models.
• Adheres to CMS guidelines and Highmark policies for coding decisions.
• Supports regulatory audits with initial chart review and ranking.
• Engages in RPM coding education and annual coding summit.

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health is seeking a skilled HCC coder to support risk adjustment coding for MA, ACA, and ESRD programs. The role requires independent work across multiple coding systems, adherence to CMS guidelines, and collaboration with physicians and teams to ensure accurate documentation and compliant coding.

Responsibilities include supporting RPM projects, audits, and process improvements, while promoting high quality outcomes. Position is remote/office-based with travel up to 25% as needed.