Remote Risk Adjustment Coding Specialist – HCC & CPC Expert

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

Job summary

Highmark Health is seeking an experienced HCC Coder to deliver accurate risk adjustment coding for MA, ACA and ESRD programs. You will work with physicians and cross-functional teams to ensure documentation supports ICD-10 diagnoses and HCC categories.

The role involves participating in RPM projects, audits, and process improvements while maintaining CMS guidelines and Highmark policies. Remote, office-based, with travel up to 25% as needed.

Qualifications

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

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects with Retro and Prospective models.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects to address department needs and improve processes.
• 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 is seeking an experienced HCC Coder to deliver accurate risk adjustment coding for MA, ACA and ESRD programs. You will work with physicians and cross-functional teams to ensure documentation supports ICD-10 diagnoses and HCC categories.

The role involves participating in RPM projects, audits, and process improvements while maintaining CMS guidelines and Highmark policies. Remote, office-based, with travel up to 25% as needed.