Remote HCC & Risk Adjustment Coder

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

Job summary

Highmark Health in the United States seeks a skilled HCC coder to support risk adjustment coding for MA/ACA with RPM initiatives. You will interpret clinical documentation into ICD-10 diagnoses and HCC categories, follow CMS guidelines, and collaborate with physicians, Quality, Compliance and leadership to ensure accurate data capture.

The role is remote office-based with travel 0-25% and requires CPC/CRC/CCS/RHIT certifications and 3 years of HCC coding experience.

Qualifications

• 3 years HCC coding and/or coding and billing experience.
• Preferred 5 years HCC coding and/or coding and billing.
• Certified Professional Coder (CPC) and related certifications.
• Associate degree in medical billing/coding preferred.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects; codes across models.
• Adheres to CMS guidelines and RPM coding requirements.
• Supports regulatory audits with chart reviews and ranking.
• Participates in ad-hoc projects and educational meetings.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

Associate degree preferred

CPC Certification

CRC Certification

CCS Certification

RHIT Certification

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health in the United States seeks a skilled HCC coder to support risk adjustment coding for MA/ACA with RPM initiatives. You will interpret clinical documentation into ICD-10 diagnoses and HCC categories, follow CMS guidelines, and collaborate with physicians, Quality, Compliance and leadership to ensure accurate data capture.

The role is remote office-based with travel 0-25% and requires CPC/CRC/CCS/RHIT certifications and 3 years of HCC coding experience.