Remote HCC Coding Specialist - Risk Adjustment Expert

Highmark Health; Wilmington (VT); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Inc. is seeking a skilled HCC coder to support risk adjustment coding for Medicare Advantage, ACA, and ESRD projects.

You will work with physicians and teams to ensure accurate ICD-10 diagnoses and HCC categories while following CMS guidelines and Highmark policies. Responsibilities include coding across multiple models, reviewing charts for audits, and participating in RPM coding education sessions to drive quality and compliance.

Qualifications

• 3 years HCC coding and/or coding and billing experience.
• 5 years HCC coding and/or coding and billing (preferred).
• CPC, CRC, CCS, RHIT certifications required.
• Associate degree in medical billing/coding preferred.
• Strong attention to detail and communication skills.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD; flexes between models and projects.
• Works independently in various coding applications and EMR systems to support goals.
• Adheres to CMS guidelines and Highmark policies for coding decisions.
• Assists with regulatory audits by performing initial chart reviews.
• Engages in RPM coding education meetings and annual coding Summit.

Skills

HCC Coding

Attention to Detail

Communication Skills

Written Communications

MS Office

Education

Associate degree in medical billing/coding

Certifications: CPC, CRC, CCS, RHIT

Tools

EMR Systems

Coding Applications

Job description

Highmark Inc. is seeking a skilled HCC coder to support risk adjustment coding for Medicare Advantage, ACA, and ESRD projects.

You will work with physicians and teams to ensure accurate ICD-10 diagnoses and HCC categories while following CMS guidelines and Highmark policies. Responsibilities include coding across multiple models, reviewing charts for audits, and participating in RPM coding education sessions to drive quality and compliance.