Senior HCC Coding Specialist — Remote Risk Adjustment

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

Job summary

Highmark Health is seeking a skilled HCC coder to support Risk Adjustment initiatives for MA, ACA and ESRD programs. You will apply CMS guidelines to translate physician documentation into ICD10 codes and HCC categories while ensuring RPM and audit readiness.

You will collaborate with physicians, Quality, Compliance and enterprise partners to improve documentation and coding accuracy, participate in training, and contribute to process improvements in a remote office setting.

Qualifications

• 3 years HCC coding and/or coding and billing.
• 5 years HCC coding and/or coding and billing (preferred).
• Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT).

Responsibilities

• Performs HCC coding on projects for MA, ACA, and ESRD across various models.
• Assists with Regulatory Audits by performing first coding review and ranking of charts.
• Participates on ad-hoc projects per Leadership direction to improve processes.
• 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

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Education

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

Job description

Highmark Health is seeking a skilled HCC coder to support Risk Adjustment initiatives for MA, ACA and ESRD programs. You will apply CMS guidelines to translate physician documentation into ICD10 codes and HCC categories while ensuring RPM and audit readiness.

You will collaborate with physicians, Quality, Compliance and enterprise partners to improve documentation and coding accuracy, participate in training, and contribute to process improvements in a remote office setting.