Remote HCC & Risk Adjustment Coding Specialist

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

Job summary

Highmark Health seeks an experienced HCC coder to support Medicare Advantage, ACA, and RADV audits from a remote office-based role. You will apply CMS guidelines to interpret physician documentation into ICD-10 diagnoses and HCC categories, collaborating with physicians and cross-functional teams.

The ideal candidate holds CPC/CRC/CCS/RHIT or similar certifications, with 3 years of HCC coding experience and strong attention to detail.

Qualifications

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD; works independently across coding applications and EMR systems to support goals.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects to address department needs; provides recommendations for process improvements.
• Engages in RPM Coding educational meetings and annual coding Summit.

Skills

Critical Thinking

Attention to Detail

Written and Oral Presentation Skills

Written Communications

Communication Skills

HCC Coding

Education

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

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health seeks an experienced HCC coder to support Medicare Advantage, ACA, and RADV audits from a remote office-based role. You will apply CMS guidelines to interpret physician documentation into ICD-10 diagnoses and HCC categories, collaborating with physicians and cross-functional teams.

The ideal candidate holds CPC/CRC/CCS/RHIT or similar certifications, with 3 years of HCC coding experience and strong attention to detail.