Lead Hierarchical Condition Category (HCC) Coding Specialist (Remote)

Highmark Health

📍 US 🌐 Remote Medical Billing & Coding Posted 2026-05-30

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Job Description

Company : Highmark Inc. Job Description : JOB SUMMARY This job will deliver value to the Health Plan and its beneficiaries enrolled in risk-adjusted government programs (MA and ACA) through Hierarchical Condition Category (HCC) coding, medical coding, clinical terminology and anatomy/physiology, CMS coding guidelines, and support of Risk Adjustment Data Validation (RADV) audits. Conducts quality a

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8:00 AM

Coders start the day by pulling their assigned chart queue. In a hospital setting, an inpatient coder might work 15–25 charts per…

8:30 AM

Open the first chart. Read the operative report, discharge summary, and physician notes. Assign the principal diagnosis code (the…

10:30 AM

Encounter a complex chart — a patient with multiple comorbidities and a surgical complication. You spend extra time to capture eve…

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