Remote HCC Coding Specialist — Risk Adjustment Expert

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

Job summary

Highmark Inc. is seeking a Hierarchical Condition Category (HCC) Coding Specialist to support CMS-based risk adjustment coding for MA, ACA, and ESRD programs. This remote-friendly role collaborates with physicians and teams to ensure accurate ICD-10 and HCC classification, while supporting RPM coding initiatives and audits.

The ideal candidate has 3+ years in HCC coding, relevant CPC/CRC/CCS/RHIT credentials, and strong attention to detail, communication, and documentation improvement skills.

Qualifications

• 3 years of experience in HCC coding and/or coding and billing.
• Knowledge of CMS coding guidelines and RADV audits.
• Experience with documentation improvement and RPM-related coding.

Responsibilities

• Perform HCC coding on MA, ACA, and ESRD projects.
• Adhere to CMS guidelines and Highmark policies.
• Support regulatory audits and collaborative initiatives.

Skills

HCC Coding

CMS Guidelines

Attention to Detail

Critical Thinking

MS Word

Education

Associate degree in medical billing/coding

CPC/CRC/CCS/RHIT certification

Tools

MS Excel

Outlook

PowerPoint

Job description

Highmark Inc. is seeking a Hierarchical Condition Category (HCC) Coding Specialist to support CMS-based risk adjustment coding for MA, ACA, and ESRD programs. This remote-friendly role collaborates with physicians and teams to ensure accurate ICD-10 and HCC classification, while supporting RPM coding initiatives and audits.

The ideal candidate has 3+ years in HCC coding, relevant CPC/CRC/CCS/RHIT credentials, and strong attention to detail, communication, and documentation improvement skills.