Remote HCC Coding Specialist: Risk Adjustment Expert

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

Job summary

Highmark Health is seeking a skilled HCC Coder to deliver compliant risk adjustment coding for MA and ACA programs. You will work with physicians and internal partners to ensure accurate ICD-10 and HCC classifications while adhering to CMS guidelines.

The role supports RPM projects and process improvements, with remote office-based work and travel up to 25%. A CPC/CRC/CCS/RHIT or equivalent certification is preferred along with 3 years of relevant HCC coding experience.

Qualifications

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

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD; uses multiple coding models and systems to support departmental goals.
• Assists with regulatory audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects; recommends process improvements and efficiencies.
• Engages in RPM coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

Microsoft Office SuiteProficient

MS365 & Teams

Education

Associate degree (preferred)

Tools

CPC

CRC

CCS

RHIT

Job description

Highmark Health is seeking a skilled HCC Coder to deliver compliant risk adjustment coding for MA and ACA programs. You will work with physicians and internal partners to ensure accurate ICD-10 and HCC classifications while adhering to CMS guidelines.

The role supports RPM projects and process improvements, with remote office-based work and travel up to 25%. A CPC/CRC/CCS/RHIT or equivalent certification is preferred along with 3 years of relevant HCC coding experience.