Remote HCC & Risk Adjustment Coder

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

Job summary

Highmark Inc. in Connecticut seeks an experienced HCC coder to perform coding on Medicare Advantage and ACA projects, ensuring CMS guidelines are followed and supporting RPM initiatives. The role emphasizes accuracy, coding audits, and collaboration with physicians, compliance, and leadership to improve risk adjustment processes.

Remote office-based with travel 0%–25% may be required. Required certifications CPC, CRC, CCS, RHIT and at least 3 years of HCC coding experience; an associate degree

Qualifications

• 3 years HCC coding and/or coding and billing
• CPC, CRC, CCS, RHIT certifications are required

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects to address department needs and improve processes.
• Engages in RPM coding educational meetings and annual coding Summit.
• Other duties as assigned.

Skills

HCC Coding

Attention to Detail

Critical Thinking

Written and Oral Presentation Skills

Communication Skills

MS Office Proficient

MS Word

Excel

Outlook

PowerPoint

Education

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Inc. in Connecticut seeks an experienced HCC coder to perform coding on Medicare Advantage and ACA projects, ensuring CMS guidelines are followed and supporting RPM initiatives. The role emphasizes accuracy, coding audits, and collaboration with physicians, compliance, and leadership to improve risk adjustment processes.

Remote office-based with travel 0%–25% may be required. Required certifications CPC, CRC, CCS, RHIT and at least 3 years of HCC coding experience; an associate degree