Risk Adjustment Medical Record Coder

BlueCross BlueShield of Tennessee • Chattanooga, TN

4d • Remote

About The Position

The Risk Adjustment & Quality Division at BCBST is seeking a skilled Risk Adjustment Medical Record Coder to support our mission of delivering accurate and compliant coding practices. What You’ll Do: In this role, you will perform first-pass reviews of member medical records to identify and capture active conditions that map to risk values. This is a remote, day-shift position with flexibility to work up to 8 additional hours per week in accordance with BCBST policy. Preferred Qualifications: CRC (Certified Risk Adjustment Coder) certification is a plus. If not currently certified, you must obtain it within one year of hire. Strong expertise in HCC (Hierarchical Condition Category) coding, with experience in MA (Medicare Advantage) and Affordable Care Act (ACA) programs highly preferred. What Sets You Apart: Self-motivated and proactive, thriving in a remote work environment A true team player, ready to engage in team chats and support colleagues A learner, eager to grow and adapt in a constantly evolving industry

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.

Nice To Haves

• CRC (Certified Risk Adjustment Coder) certification is a plus.
• If not currently certified, you must obtain it within one year of hire.
• Strong expertise in HCC (Hierarchical Condition Category) coding, with experience in MA (Medicare Advantage) and Affordable Care Act (ACA) programs highly preferred.
• Self-motivated and proactive, thriving in a remote work environment
• A true team player, ready to engage in team chats and support colleagues
• A learner, eager to grow and adapt in a constantly evolving industry

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.
• ICD-10 Coding assessment is required.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees