Base: $27.02 - $41.85 ph; bonus/equity: not specif...
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Hcc coding expertise
Cms coding guidelines adherence
Icd-10 diagnosis interpretation
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Highmark Health is seeking a Hierarchical Condition Category (HCC) Coding Specialist to work fully remotely. The role requires expertise in HCC coding, medical terminology, and compliance with CMS guidelines to support risk adjustment initiatives for Medicare Advantage and ACA programs.
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Job Summary
This role delivers value to the Health Plan by ensuring accurate risk adjustment coding for Medicare Advantage and Affordable Care Act beneficiaries.
The specialist performs HCC coding on various projects including Retro and Prospective models while adhering to strict CMS Guidelines.
Candidates must maintain high accuracy and productivity standards while supporting Regulatory Audits and engaging in continuous professional development.
Matching Summary
Match Score: 75
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Highmark Health is seeking a Hierarchical Condition Category (HCC) Coding Specialist to work fully remotely. The role requires expertise in HCC coding, medical terminology, and compliance with CMS guidelines to support risk adjustment initiatives for Medicare Advantage and ACA programs.
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Salary
Base: $27.02 - $41.85 per hour; Bonus/Equity: Not specified; Benefits: Not specified
Skills & Requirements
Must-have
HCC coding expertise
CMS coding guidelines adherence
ICD-10 diagnosis interpretation
Risk Adjustment Data Validation audits
Remote patient monitoring projects
Nice-to-have
Process improvement recommendations
Provider education experience
Strong written communication skills
Team collaboration abilities
Critical thinking in clinical contexts
Key Requirements
3 years HCC coding experience required
Certified Professional Coder (CPC) or equivalent certification
Associate degree preferred in medical billing/coding