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 our mission of delivering accurate and compliant coding practices. 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.

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.
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree