Hybrid Risk Adjustment Coder and Guidelines Lead

CareFirst BlueCross BlueShield; Baltimore (MD); Hybrid; USD 51,984 - 95,304; Full time

Job summary

CareFirst BlueCross BlueShield is looking for a Risk Adjustment Coding Specialist in Baltimore, Maryland. This role involves reviewing and coding medical records, ensuring compliance with federal and state guidelines. You will also develop coding guidelines and provide guidance to junior specialists. The position supports a hybrid working model and offers a salary range between $51,984 and $95,304.

The ideal candidate will have an Associate degree in Health Information Technology and at least 3 years of coding experience. Required certifications include CCS or CPC upon hire.

Qualifications

• 3 years of risk adjustment/HCC coding experience required.
• CCS-Certified Coding Specialist or CPC, CCS-P, CRC required upon hire.
• RHIT or RHIA preferred upon hire.

Responsibilities

• Verify accuracy and appropriateness of diagnosis codes based on medical documentation.
• Collaborate with leadership and vendors on medical record diagnoses.
• Guide and mentor less experienced staff.

Skills

Adobe Acrobat Professional

Microsoft Word

Microsoft Excel

Claims Processing

Facets

Communication skills

Customer service

Education

Associate degree in Health Information Technology or related field

Job description

CareFirst BlueCross BlueShield is looking for a Risk Adjustment Coding Specialist in Baltimore, Maryland. This role involves reviewing and coding medical records, ensuring compliance with federal and state guidelines. You will also develop coding guidelines and provide guidance to junior specialists. The position supports a hybrid working model and offers a salary range between $51,984 and $95,304.

The ideal candidate will have an Associate degree in Health Information Technology and at least 3 years of coding experience. Required certifications include CCS or CPC upon hire.