Remote HCC Coding Specialist Risk Adjustment Expert

Highmark Health; Salem (NH); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health is seeking a skilled HCC coder to join a remote, office-based team. You will work on MA, ACA, and ESRD projects, translating physician documentation into ICD-10 codes and HCC categories while following CMS guidelines and Highmark policies.

You will participate in audits, provider education, and process improvements, supporting RPM across CMS requirements and risk adjustment initiatives.

Qualifications

• 3 years HCC coding and/or coding and billing
• Experience with RPM coding and CMS rules is a plus

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects across models
• Adheres to CMS Guidelines and Highmark policies
• Supports RPM coding and coding audits
• Participates in ad-hoc projects and supports process improvements
• Engages in RPM coding education meetings

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

CMS Guidelines

Job description

Highmark Health is seeking a skilled HCC coder to join a remote, office-based team. You will work on MA, ACA, and ESRD projects, translating physician documentation into ICD-10 codes and HCC categories while following CMS guidelines and Highmark policies.

You will participate in audits, provider education, and process improvements, supporting RPM across CMS requirements and risk adjustment initiatives.