Remote HCC Coding Specialist - Risk Adjustment Expert

Highmark Health; Yuma (AZ); A distancia; USD 37.000 - 58.000; Jornada completa

Descripción de la vacante

Highmark Health seeks an experienced HCC Coder to deliver accurate risk adjustment coding for Medicare Advantage and ACA populations. The role supports RPM projects and CMS guidelines, collaborating with physicians and internal teams to ensure high-quality documentation and coding accuracy.

The position emphasizes expertise in HCC modeling, regulatory audits, and process improvement, with a remote office-based arrangement and travel up to 25%.

Formación

• 3 years HCC coding and/or coding and billing experience.
• Certified Professional Coder (CPC) and other coding credentials.
• Strong knowledge of CMS guidelines and RADV audits.

Responsabilidades

• Performs HCC coding on projects for MA, ACA, and ESRD in Retro and Prospective models.
• Assists with regulatory audits by performing first coding review and ranking of charts.
• Participates in ad-hoc projects and suggests process improvements.
• Engages in RPM Coding educational meetings and annual coding Summit.

Conocimientos

HCC Coding

Attention to Detail

Communication Skills

Critical Thinking

Educación

Associate degree in medical billing/coding

Herramientas

MS Office Suite Proficient

Descripción del empleo

Highmark Health seeks an experienced HCC Coder to deliver accurate risk adjustment coding for Medicare Advantage and ACA populations. The role supports RPM projects and CMS guidelines, collaborating with physicians and internal teams to ensure high-quality documentation and coding accuracy.

The position emphasizes expertise in HCC modeling, regulatory audits, and process improvement, with a remote office-based arrangement and travel up to 25%.