Remote Medical Record Auditor & Coding QA Lead

Blue Cross Blue Shield of Alabama; Birmingham (AL); On-site; USD 70,000 - 90,000; Full time

Job summary

Blue Cross and Blue Shield of Alabama is hiring a Medical Record Auditor to evaluate coded medical records and lead audits across internal and external coders. The role focuses on ensuring CMS guideline compliance and improving overall coding accuracy.

You will provide feedback, support policy development, and collaborate with clinical educators and networks to report coding quality. The position emphasizes strong attention to detail, CPC certification, and extensive knowledge of ICD-9/10, CPT,

Qualifications

• Bachelor's degree required or pursued; strong coding knowledge welcomed.
• 5 years of Certified Professional Coder (CPC) experience and project support experience.
• Knowledge of Medicare Advantage coding regulations.
• Extensive training in medical terminology, disease processes, and pharmacology.
• Proficiency with ICD-9/10, CPT, and CMS coding principles and guidelines; risk/HEDIS knowledge.
• Excellent written and verbal communication; highly detailed oriented.
• Experience with coding quality audits on medical records.

Responsibilities

• Lead audits of medical records for accuracy and CMS compliance.
• Score vendors, internal coders, and external coders on coding quality.
• Provide feedback to medical record coders and vendors; resolve coding questions with clinical teams.
• Assist with policy development and documentation of health risk assessments; respond to coding inquiries.

Skills

Attention to detail

Written and verbal communication

Microsoft Office proficiency

Education

Bachelor's Degree

Tools

Microsoft Office

CMS coding guidelines

Job description

Blue Cross and Blue Shield of Alabama is hiring a Medical Record Auditor to evaluate coded medical records and lead audits across internal and external coders. The role focuses on ensuring CMS guideline compliance and improving overall coding accuracy.

You will provide feedback, support policy development, and collaborate with clinical educators and networks to report coding quality. The position emphasizes strong attention to detail, CPC certification, and extensive knowledge of ICD-9/10, CPT,