Remote HCC Coding Specialist | Risk Adjustment Expert

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

Job summary

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will translate physician documentation into ICD-10 diagnoses and HCC categories while adhering to CMS guidelines and Highmark policies.

Role involves collaboration with physicians, quality, compliance, and leadership to ensure accurate risk adjustment coding. Remote office-based with 0–25% travel, requiring CPC/CRC/CCS/RHIT certifications and 3+ years of HCC experience.

Qualifications

• Certified Professional Coder (CPC) required.
• Certified Risk Coder (CRC) required.
• Certified Coding Specialist (CCS) required.
• Registered Health Information Technician (RHIT) required.
• 3 years HCC coding and/or coding and billing experience required.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects; handles multiple models and coding systems.
• Assists with regulatory audits by performing first coding review and chart ranking.
• Participates in ad-hoc projects; suggests process improvements and efficiencies.
• Engages in RPM coding education meetings and annual coding Summit.
• Other duties as assigned.

Skills

HCC Coding

Attention to Detail

Critical Thinking

Written Communications

Written and Oral Presentation Skills

Communication Skills

MS Word/Excel/Outlook/PowerPoint

MS365 & Teams

Education

Associate degree in medical billing/coding

Tools

EMR systems

Job description

Highmark Health is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will translate physician documentation into ICD-10 diagnoses and HCC categories while adhering to CMS guidelines and Highmark policies.

Role involves collaboration with physicians, quality, compliance, and leadership to ensure accurate risk adjustment coding. Remote office-based with 0–25% travel, requiring CPC/CRC/CCS/RHIT certifications and 3+ years of HCC experience.