Risk Adjustment Medical Record Coder

BlueCross BlueShield of Tennessee • Chattanooga, TN

1d • Remote

About The Position

The Risk Adjustment & Quality Division at BCBST is seeking a skilled Risk Adjustment Medical Record Coder to support their mission of delivering accurate and compliant coding practices. In this remote, day-shift position, the coder will perform first-pass reviews of member medical records to identify and capture active conditions that map to risk values. BCBST is Tennessee's largest health benefit plan company, helping Tennesseans find their own unique paths to good health since 1945. They empower employees to thrive both independently and collaboratively, creating a collective impact on the lives of their members. They foster a culture where innovation is encouraged, including using AI enabled tools responsibly to support everyday work. BCBST is a remote-first organization, hiring employees for remote positions from across the U.S. with the exception of California, Massachusetts, New Hampshire, New Jersey, and New York.

Requirements

• Associates degree or equivalent work experience required. Equivalent experience is defined as 2 years of professional work experience.
• 1 year - Progressive medical coding and health care experience required.
• Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA).
• Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within one year, after completed training.
• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).
• Proven analytical and problem-solving skills and ability to perform non-routine analytical tasks.
• Must be a team player, be organized and have the ability to handle multiple projects.
• Excellent oral and written communication skills.
• Strong interpersonal and organizational skills.
• Understanding of ICD-10 coding standards required.
• ICD-10 Coding assessment is required.

Nice To Haves

• CRC (Certified Risk Adjustment Coder) certification is a plus.
• Strong expertise in HCC (Hierarchical Condition Category) coding, with experience in MA (Medicare Advantage) and Affordable Care Act (ACA) programs highly preferred.

Responsibilities

• Maintain compliance with CMS risk adjustment diagnosis coding guidelines.
• Perform comprehensive 1st pass reviews of medical records and physician assessment forms (HCC coding).
• Assist with the intake and quality assurance of medical records as necessary.
• Perform or participate in special projects as directed by management.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees