Remote Risk Adjustment Coder for Medicare/HCC

BlueCross BlueShield of Tennessee; United States; Remote; USD 55,000 - 85,000; Full time

Job summary

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring a Risk Adjustment Medical Record Coder to perform first-pass reviews of member records, identify active conditions, and map them to risk values.

This role supports CMS risk adjustment coding within our Risk Adjustment & Quality Division in a remote setting. Ideal candidates hold AHIMA or AAPC certification (CPC, CCS, RHIT, RHIA) and will strive to obtain CRC within a year.

Qualifications

• Associates degree or equivalent work experience required.
• Equivalent experience defined as 2 years of professional work experience.
• 1 year of progressive medical coding and health care experience required.
• Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA) required.
• Must acquire the CRC certificate from AAPC within one year, after completed training.
• Ability to work independently with minimal supervision or in a team environment.
• Proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint).
• Excellent oral and written communication skills.
• Strong interpersonal and organizational skills.
• Understanding of ICD-10 coding standards required.

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.

Skills

Analytical skills

Communication skills

Teamwork

Organizational skills

Microsoft Office

ICD-10 coding knowledge

Education

Associates degree or equivalent work experience

Tools

Microsoft Office

Job description

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring a Risk Adjustment Medical Record Coder to perform first-pass reviews of member records, identify active conditions, and map them to risk values.

This role supports CMS risk adjustment coding within our Risk Adjustment & Quality Division in a remote setting. Ideal candidates hold AHIMA or AAPC certification (CPC, CCS, RHIT, RHIA) and will strive to obtain CRC within a year.