Highmark · 3 weeks ago
Hierarchical Condition Category (HCC) Coding Specialist
Erie-Meadville Area
Full-time
Onsite
Mid, Senior Level
$26.49/hr - $41.03/hr
3+ years expHighmark Inc. is a health plan provider that focuses on delivering value to its beneficiaries through risk adjustment coding. The HCC Coding Specialist will be responsible for performing HCC coding for various government programs, ensuring compliance with CMS guidelines, and supporting quality initiatives in coding accuracy and documentation improvement.
Health CareHealth InsuranceInsuranceWellness
Responsibilities
Performs HCC coding on projects for MA, ACA, and End Stage Renal Disease (ESRD). Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals. Adheres to CMS Guidelines for Coding and Highmark’s Policy and Procedures to guide HCC coding decision making. Maintains RPM coding accuracy and productivity requirements
Assists with Regulatory Audits by performing first coding review and ranking of charts. Build partnerships and work within coding teams and internal partners critical to HCC coding
Participates on ad-hoc projects per the direction of Leadership to address the needs of the department. Provides recommendations for process improvements and efficiencies
Engages in RPM Coding educational meetings and annual coding Summit
Other duties as assigned
Qualification
Required
3 years HCC coding and/or coding and billing
Certified Professional Coder (CPC)
Certified Risk Coder (CRC)
Certified Coding Specialist (CCS)
Registered Health Information Technician (RHIT)
Critical Thinking
Attention to Detail
Written and Oral Presentation Skills
Written Communications
Communication Skills
HCC Coding
MS Word, Excel, Outlook, PowerPoint
Microsoft Office Suite Proficient/ - MS365 & Teams
Preferred
Associate degree in medical billing/coding, health insurance, healthcare or related field preferred
5 years HCC coding and/or coding and billing
Company
Highmark
Highmark provides health insurance plans for individuals and businesses.
10001+ employees
H1B Sponsorship
Highmark has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (11)
2024 (7)
2023 (19)
2022 (21)
2021 (18)
2020 (23)
Funding
Current Stage
Late StageTotal Funding
$27.3M2018-04-06Grant· $25M
2014-08-07Grant· $2.3M
Leadership Team
Deborah Rice-Johnson
CEO, Diversified Businesses at Highmark Inc. and Chief Growth Officer
Paul Sikora
CTO Provider Services
Recent News
2025-12-11
Company data provided by crunchbase