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Posted: 9/23/2026HCC Coding Specialist
Highmark HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in HCC coding for Medicare Advantage and ACA programs, applying CMS guidelines and maintaining coding accuracy. Strong communication skills and critical thinking abilities support effective collaboration and process improvements within coding teams.
Highest-signal resume keywords
HCC CodingCertified Professional Coder (CPC)Certified Risk Coder (CRC)Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)
About the role
Key responsibilities & impact- Deliver value to the Health Plan and beneficiaries enrolled in risk-adjusted government programs such as Medicare Advantage and Affordable Care Act programs
- Perform HCC coding for Medicare Advantage, ACA, and End Stage Renal Disease projects
- Flex between Retro and Prospective coding projects across MA, ESRD, and ACA HCC models
- Work independently in coding applications and electronic medical record systems
- Apply CMS coding guidelines and Highmark policies and procedures to HCC coding decisions
- Maintain RPM coding accuracy and productivity requirements
- Assist with regulatory audits by performing first coding review and ranking charts
- Build partnerships and work within coding teams and internal partners
- Participate in ad-hoc projects directed by leadership
- Provide recommendations for process improvements and efficiencies
- Participate in RPM coding educational meetings and the annual coding Summit
- Perform other duties as assigned
Requirements
What you’ll need- 3 years HCC coding and/or coding and billing required
- One of the following certifications required: Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT)
- Associate degree in medical billing/coding, health insurance, healthcare or related field preferred
- Critical thinking
- Attention to detail
- Written and oral presentation skills
- Written communications
- Communication skills
- HCC coding
- Proficiency with MS Word, Excel, Outlook, PowerPoint, Microsoft Office Suite, MS365, and Teams
- English; no additional language required
- Travel requirement: 0%–25%
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 CodingCoding and BillingCritical ThinkingAttention to Detail
Soft Skills
Written CommunicationOral Presentation SkillsCommunication Skills
Tools & Technologies
MS WordExcelOutlookPowerPointMicrosoft Office SuiteMS365Teams
Certifications & Qualifications
Certified Professional Coder (CPC)Certified Risk Coder (CRC)Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)
Industry Keywords
Medicare AdvantageAffordable Care ActEnd Stage Renal DiseaseCMS Coding GuidelinesRegulatory Audits