Remote HCC Coding Specialist — Risk Adjustment Expert

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

Job summary

Highmark Health seeks an experienced HCC coder to support Medicare Advantage, ACA, and ESRD risk-adjusted coding. You will translate physician documentation into ICD-10 diagnoses and HCC categories, ensuring CMS guidelines and RPM requirements are met in a remote office setting.

You will collaborate with physicians and cross-functional teams to improve documentation, participate in audits, and drive process improvements for accurate risk adjustment coding.

Qualifications

• Critical thinking and attention to detail are essential.
• Experience with HCC coding and medical coding required.
• Strong written and verbal communication skills are necessary.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects across models.
• Assists with regulatory audits through initial chart reviews.
• Participates in ad-hoc projects and process improvements.
• Engages in RPM coding educational activities 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

Tools

EMR systems

Coding applications

Job description

Highmark Health seeks an experienced HCC coder to support Medicare Advantage, ACA, and ESRD risk-adjusted coding. You will translate physician documentation into ICD-10 diagnoses and HCC categories, ensuring CMS guidelines and RPM requirements are met in a remote office setting.

You will collaborate with physicians and cross-functional teams to improve documentation, participate in audits, and drive process improvements for accurate risk adjustment coding.