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HCC Coding Specialist
Highmark Health. Deliver value to the Health Plan and beneficiaries enrolled in risk-adjusted government programs such as Medicare Advantage and Affordable Care Act programs .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in HCC coding, including proficiency in applying CMS guidelines and maintaining coding accuracy. Strong communication skills support effective collaboration and documentation improvement within healthcare settings.
Highest-signal resume keywords
HCC CodingCertified Professional Coder (CPC)Certified Risk Coder (CRC)Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)
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 CodingICD10 Diagnosis InterpretationCoding and BillingRegulatory ComplianceData Analysis
Soft Skills
Critical ThinkingAttention to DetailWritten CommunicationOral Presentation SkillsCollaboration
Tools & Technologies
Electronic Medical Record SystemsMicrosoft Office SuiteMS365MS WordExcelOutlookPowerPointTeams
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 GuidelinesHIPAA Compliance
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 using different MA, ESRD, and ACA HCC Models
- Work independently in coding applications and electronic medical record systems
- Apply CMS Guidelines for Coding and Highmark policies and procedures
- 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 departmental projects
- Recommend process improvements and efficiencies
- Participate in RPM coding educational meetings and annual coding Summit
- Analyze physician documentation and interpret it into ICD10 diagnoses and HCC disease categories
- Support documentation improvement, provider education, report analysis, and process improvements
Requirements
What you’ll need- 3 years of experience in HCC coding and/or coding and billing
- Certified Professional Coder (CPC) OR Certified Risk Coder (CRC) OR Certified Coding Specialist (CCS) OR Registered Health Information Technician (RHIT)
- Skills in HCC Coding
- Proficiency with MS Word, Excel, Outlook, PowerPoint
- Proficiency with Microsoft Office Suite, MS365, and Teams
- Critical thinking
- Attention to detail
- Written and oral presentation skills
- Written communications
- Communication skills
- Ability to comply with CMS coding guidelines and company policies
- Ability to protect confidential customer information and comply with HIPAA and data security requirements
- Associate degree in medical billing/coding, health insurance, healthcare, or related field preferred (not required)
Benefits
Comp & perks- Remote work
- Annual coding Summit
- Travel requirement of 0%–25%