Remote HCC & Risk Adjustment Coder

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

Job summary

Highmark Health is seeking a remote HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will apply HCC coding, clinical terminology, and CMS guidelines across multiple models to ensure accurate risk adjustment data.

The role collaborates with physicians, Quality, Compliance, and leadership to improve documentation and coding quality, while supporting RPM initiatives and audits.

Qualifications

• 3 years HCC coding and/or coding and billing
• Associate degree in medical billing/coding (preferred)
• Relevant CPC/CRC/CCS/RHIT certifications required (listed)

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects across models.
• Assists with regulatory audits via initial chart review.
• Participates in ad-hoc projects and process improvement.
• Engages in RPM coding education and annual coding Summit.
• Other duties as assigned.

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

CPC, CRC, CCS, RHIT certifications

Tools

EMR systems

CMS Guidelines

Job description

Highmark Health is seeking a remote HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will apply HCC coding, clinical terminology, and CMS guidelines across multiple models to ensure accurate risk adjustment data.

The role collaborates with physicians, Quality, Compliance, and leadership to improve documentation and coding quality, while supporting RPM initiatives and audits.