Remote HCC Coding Specialist | Risk Adjustment Expert

Highmark Health; New Jersey; Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Health is seeking a skilled HCC coder to support risk adjustment coding for MA, ACA, and ESRD projects. The role focuses on accurate ICD10/HCC capture, auditing, and education across CMS guidelines. You will collaborate with physicians and cross-functional teams to improve documentation and coding quality.

The position requires CPC/CRC/CCS/RHIT credentials and 3 years of HCC coding experience, with remote-office flexibility and 0–25% travel. A background in MS Office tools is essential.

Qualifikationen

• 3 years HCC coding and/or coding and billing
• Experience with MA/ACA and ESRD HCC models
• CMS coding guidelines knowledge and RPM coding
• Ability to work across multiple EMR systems and audits

Aufgaben

• Performs HCC coding on projects for MA, ACA, and ESRD. Flexes between coding projects with different models; works independently in various coding applications and EMR systems.
• Assists with Regulatory Audits by performing first coding review and ranking of charts; builds partnerships within coding teams and internal partners.
• Participates on ad-hoc projects per Leadership direction; provides recommendations for process improvements and efficiencies.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Kenntnisse

HCC Coding

Critical Thinking

Attention to Detail

Written Communications

Communication Skills

Written and Oral Presentation Skills

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Ausbildung

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

Certified Professional Coder (CPC)

Certified Risk Coder (CRC)

Certified Coding Specialist (CCS)

Registered Health Information Technician (RHIT)

Jobbeschreibung

Highmark Health is seeking a skilled HCC coder to support risk adjustment coding for MA, ACA, and ESRD projects. The role focuses on accurate ICD10/HCC capture, auditing, and education across CMS guidelines. You will collaborate with physicians and cross-functional teams to improve documentation and coding quality.

The position requires CPC/CRC/CCS/RHIT credentials and 3 years of HCC coding experience, with remote-office flexibility and 0–25% travel. A background in MS Office tools is essential.