Remote HCC Medical Coder & Risk Adjustment Specialist

Highmark Health; Bismarck (ND); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health seeks a detail-oriented HCC coder to perform complex coding for Medicare Advantage, ACA, and ESRD projects. You will work with physicians and teams to ensure accurate documentation and coding in line with CMS guidelines.

You will participate in audits, coding reviews, and process improvements, contributing to compliant risk adjustment programs and ongoing education across the organization.

Qualifications

• Experience in HCC coding and risk adjustment coding.
• Familiarity with CMS guidelines and RADV audits.
• Knowledge of ICD-10 coding and medical terminology.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects across CMS models.
• Collaborates with physicians and cross-functional teams to ensure coding accuracy.
• Participates in audits and educational sessions to improve processes.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

Microsoft Office Suite

MS365

Teams

Education

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

Tools

CPC

CRC

CCS

RHIT

Job description

Highmark Health seeks a detail-oriented HCC coder to perform complex coding for Medicare Advantage, ACA, and ESRD projects. You will work with physicians and teams to ensure accurate documentation and coding in line with CMS guidelines.

You will participate in audits, coding reviews, and process improvements, contributing to compliant risk adjustment programs and ongoing education across the organization.