Hierarchical Condition Category (hcc) Coding Specialist

Highmark Health

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
** 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. **

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

** 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. **

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
  • 5 years HCC coding experience preferred

Work Rights

Not specified

Tailored Resume

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