Hierarchical Condition Category (HCC) Coding Specialist

The Hierarchical Condition Category (HCC) Coding Specialist at Highmark Inc. delivers value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs like Medicare Advantage and the Affordable Care Act. The role involves analyzing physician documentation to interpret ICD-10 diagnoses and HCC disease categories, ensuring compliance with CMS requirements and supporting Remote Patient Monitoring risk adjustment projects. This position requires collaboration with physicians, team members, and leadership to drive accurate risk adjustment coding and documentation improvement.