Remote HCC Risk Adjustment Coding Specialist

Highmark Health; Oklahoma City (OK); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Health in the United States is seeking a Risk Adjustment Coder to support Medicare Advantage and ACA programs. You will perform HCC coding for MA, ACA and ESRD, follow CMS guidelines, and support RPM projects to ensure compliant documentation and accurate risk capture.

You will collaborate with physicians, Quality, Compliance and Enterprise leaders to drive improvements. Requirements include CPC/CRC/CCS/RHIT certifications and at least 3 years of HCC coding experience; remote-office

Qualifications

• 3 years HCC coding and/or coding and billing
• Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD. Works independently across MA/ESRD/ACA models in various EHR systems.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects per Leadership direction to address department needs.
• Engages in RPM Coding educational meetings 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

Education

Associate degree in medical billing/coding or related field

Tools

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Job description

Highmark Health in the United States is seeking a Risk Adjustment Coder to support Medicare Advantage and ACA programs. You will perform HCC coding for MA, ACA and ESRD, follow CMS guidelines, and support RPM projects to ensure compliant documentation and accurate risk capture.

You will collaborate with physicians, Quality, Compliance and Enterprise leaders to drive improvements. Requirements include CPC/CRC/CCS/RHIT certifications and at least 3 years of HCC coding experience; remote-office