Remote Risk Adjustment Medical Coder (HCC)

Highmark Health; Baltimore (MD); Remote; USD 37,000 - 58,000; Full time

Job summary

Highmark Inc. is seeking a seasoned HCC coder to support risk adjustment coding for Medicare Advantage and ACA programs. You will work with physicians and teams to translate clinical documentation into ICD-10 diagnoses and HCC categories.

The role requires 3+ years of HCC coding, CPC/CRC/CCS/RHIT certifications, and strong attention to detail. This remote, office-based position involves RPM projects, audits, and collaboration across Compliance, Quality, and Enterprise teams.

Qualifications

• Associate degree in medical billing/coding or related field preferred.
• 3 years HCC coding and/or coding and billing required.
• 5 years HCC coding and/or coding and billing preferred.

Responsibilities

• Performs HCC coding on MA, ACA, and ESRD projects.
• Flexes between coding models across MA/ESRD/ACA.
• Adheres to CMS guidelines and RPM coding accuracy.
• Assists with regulatory audits via initial chart reviews.
• Builds partnerships with coding teams and internal partners.
• Participates in ad-hoc projects to address dept needs.
• Engages in RPM coding education and annual coding Summit.

Skills

Critical Thinking

Attention to Detail

Presentation Skills

Written Communications

Communication Skills

HCC Coding

Microsoft Office

MS Word/Excel

Education

Associate degree in medical billing/coding

Job description

Highmark Inc. is seeking a seasoned HCC coder to support risk adjustment coding for Medicare Advantage and ACA programs. You will work with physicians and teams to translate clinical documentation into ICD-10 diagnoses and HCC categories.

The role requires 3+ years of HCC coding, CPC/CRC/CCS/RHIT certifications, and strong attention to detail. This remote, office-based position involves RPM projects, audits, and collaboration across Compliance, Quality, and Enterprise teams.