Remote HCC Risk Adjustment Coding Specialist

Highmark Health; Sacramento (CA); Remote; USD 37.000 - 58.000; Vollzeit

Zusammenfassung

Highmark Inc. seeks a skilled HCC Coder to perform coding for Medicare Advantage, ACA, and related programs, ensuring accuracy and compliance with CMS guidelines. You will work across RPM projects, review documentation, and contribute to audits while partnering with physicians and teams.

The role emphasizes detail, ethics, and ongoing education in risk adjustment coding, with a remote-friendly setup and a focus on quality and regulatory adherence.

Qualifikationen

• 3 years HCC coding and/or coding and billing.
• 5 years HCC coding and/or coding and billing.
• Credentials: CPC, CRC, CCS, RHIT.
• Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.

Aufgaben

• Performs HCC coding on MA, ACA, and ESRD projects and supports RPM coding accuracy.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Collaborates with coding teams and internal partners to support HCC coding.
• Engages in RPM Coding educational meetings and annual coding Summit.
• Other duties as assigned.

Kenntnisse

HCC Coding

Attention to Detail

Critical Thinking

Written Communications

Written & Oral Presentation

Communication Skills

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Ausbildung

CPC

CRC

CCS

RHIT

Associate degree in medical billing/coding

Jobbeschreibung

Highmark Inc. seeks a skilled HCC Coder to perform coding for Medicare Advantage, ACA, and related programs, ensuring accuracy and compliance with CMS guidelines. You will work across RPM projects, review documentation, and contribute to audits while partnering with physicians and teams.

The role emphasizes detail, ethics, and ongoing education in risk adjustment coding, with a remote-friendly setup and a focus on quality and regulatory adherence.