Remote HCC Coding Specialist | Risk Adjustment Expert

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

Job summary

Highmark Health is seeking an experienced HCC Coder to deliver accurate risk adjustment coding for MA, ACA, and ESRD projects. You will work with physicians and teams to ensure compliant documentation and coding accuracy across CMS guidelines and RPM initiatives.

Remote office-based role requiring strong attention to detail, excellent communication, and robust knowledge of ICD10, HCC models, and coding tools. Certification is preferred.

Qualifications

• Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.
• 3 years HCC coding and/or coding and billing experience required.

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD with various models and systems.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects to address department needs and suggests process improvements.
• Engages in RPM Coding educational meetings and annual coding Summit.

Skills

HCC Coding

Attention to Detail

Communication Skills

Written Communications

Written and Oral Presentation Skills

Critical Thinking

Education

Associate degree in medical billing/coding

Tools

MS Word

MS Excel

MS Outlook

PowerPoint

MS Teams

Job description

Highmark Health is seeking an experienced HCC Coder to deliver accurate risk adjustment coding for MA, ACA, and ESRD projects. You will work with physicians and teams to ensure compliant documentation and coding accuracy across CMS guidelines and RPM initiatives.

Remote office-based role requiring strong attention to detail, excellent communication, and robust knowledge of ICD10, HCC models, and coding tools. Certification is preferred.