FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Senior HCC Coding Specialist
Highmark HealthSenior HCC Coding Specialist analyzing medical records and CMS guidelines for Highmark’s health plans. Supporting risk adjustment, RADV audits, provider education, and coding improvement.
Posted 9/3/2026full-timeRemote • Alabama, Alaska, Arizona, California, Colorado, Connecticut, District of Columbia, Florida, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming • 🇺🇸 United StatesSenior💰 $68,400 - $105,900 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in HCC risk adjustment coding, including ICD-10 diagnoses and HCC disease categories, while effectively collaborating on coding quality and provider education initiatives. Proficient in project management and critical thinking, with strong communication skills for delivering presentations and training.
Highest-signal resume keywords
HCC Risk Adjustment CodingICD-10 Diagnosis InterpretationCertified Professional Coder (CPC)Microsoft Office Suite ProficiencyCMS Coding Guidelines Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
HCC CodingICD-10 CodingMedical Record ReviewData CollectionCoding Quality AnalysisProvider EducationClaims Data AnalysisChart RankingProcess ImprovementCoding Trend Analytics
Soft Skills
Critical ThinkingAttention to DetailVerbal CommunicationWritten CommunicationProblem-Solving
Tools & Technologies
Microsoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointMS365Microsoft Teams
Certifications & Qualifications
Certified Professional Coder (CPC)Certified Risk Coder (CRC)Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)
Industry Keywords
Medicare AdvantageAffordable Care ActChronic Illness ManagementCMS Coding GuidelinesHighmark Policies
About the role
Key responsibilities & impact- Deliver accurate risk-adjustment coding value for Medicare Advantage and Affordable Care Act health-plan beneficiaries
- Analyze physician documentation and interpret it into ICD-10 diagnoses and HCC disease categories
- Conduct medical-record reviews and summarize documentation opportunities
- Perform quality reviews of high-risk and incremental HCCs
- Collaborate on data collection, coding quality, provider education, and outreach
- Develop and present process-improvement and training initiatives
- Complete provider and provider-group coding-trend analytics and deliver external presentations
- Perform HCC coding for MA, ACA, and ESRD projects across Retro and Prospective models
- Support RADV audit coding reviews, claims-data analysis, chart ranking, and submission preparation
- Execute assigned projects and participate in ad-hoc departmental projects
- Mentor new hires and coworkers and develop onboarding and training materials
- Support external vendor quality reviews and report findings
Requirements
What you’ll need- Associate's degree in medical billing/coding, health insurance, healthcare or related field, or relevant experience and/or education as determined by the company in lieu of degree
- 3 years in HCC risk adjustment coding experience
- One of the following required certifications: Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT)
- Experience with HCC coding for MA, ACA, and ESRD projects
- Knowledge of CMS coding guidelines and Highmark policies and procedures
- Knowledge of medical terminology
- Strong clinical knowledge related to chronic illness diagnosis, treatment, and management
- Proficiency in Microsoft Office Suite, including Word, Excel, Outlook, PowerPoint, MS365, and Teams
- Critical thinking and attention to detail
- Strong verbal and written communication, including presentation skills
- Project management and problem-solving abilities
- Ability to work collaboratively with minimal supervision
Benefits
Comp & perks- Remote work arrangement
- Travel requirement of 0%–25%