Remote HCC Coding Specialist | Risk Adjustment Expert

Highmark Health; Washington (District of Columbia); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health in Washington, DC is seeking a certified coder to perform HCC coding for MA, ACA and ESRD projects. You will work remotely from an office-based setting, collaborating with physicians, Quality, Compliance, and leadership to ensure accurate risk adjustment coding and RPM compliance.

The role requires CPC/CRC/CCS/RHIT certifications and at least 3 years of HCC coding experience, with 5 years preferred. Strong attention to detail and documentation improvements are essential.

Qualifications

• 3 years HCC coding and/or coding and billing.
• Experience in HCC coding for MA, ACA, ESRD preferred.
• Certification requirements: CPC, CRC, CCS, RHIT.

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD across models.
• Assists with regulatory audits by performing first coding review and chart ranking.
• Participates in ad-hoc projects and coding education initiatives.
• Maintains RPM coding accuracy and productivity per CMS guidelines.

Skills

HCC Coding

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

Critical Thinking

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health in Washington, DC is seeking a certified coder to perform HCC coding for MA, ACA and ESRD projects. You will work remotely from an office-based setting, collaborating with physicians, Quality, Compliance, and leadership to ensure accurate risk adjustment coding and RPM compliance.

The role requires CPC/CRC/CCS/RHIT certifications and at least 3 years of HCC coding experience, with 5 years preferred. Strong attention to detail and documentation improvements are essential.