Remote Risk Adjustment Coder — HCC & ICD-10 Expert

BlueCross BlueShield of Tennessee, Inc.; Chattanooga (TN); Remote; USD 56,000 - 76,000; Full time

Job summary

BCBST is seeking a Risk Adjustment Medical Record Coder to support accurate and compliant coding by performing first-pass reviews of member medical records to map active conditions to risk values. This remote role operates 8am-5pm ET and encourages independent work with strong team collaboration.

Ideal candidates have experience in HCC coding, Medicare Advantage, ACA, and Medicaid programs, with CRC certification planned within one year and proficiency in Microsoft Office to aid documentation

Qualifications

• Education: Associates degree or equivalent work experience required.
• Experience: 1 year - Progressive medical coding and health care experience required.
• Certifications: Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA). Must acquire the CRC certificate from AAPC within one year after training.
• Ability to work independently with minimal supervision or in a team environment.
• 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 manage multiple projects.
• Excellent oral and written communication skills.
• Strong interpersonal and organizational skills.
• Understanding of ICD-10 coding standards.

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

Microsoft Office

AHIMA or AAPC certification

Independent work

Analytical thinking

Communication skills

ICD-10 knowledge

Education

Associate degree or equivalent

Job description

BCBST is seeking a Risk Adjustment Medical Record Coder to support accurate and compliant coding by performing first-pass reviews of member medical records to map active conditions to risk values. This remote role operates 8am-5pm ET and encourages independent work with strong team collaboration.

Ideal candidates have experience in HCC coding, Medicare Advantage, ACA, and Medicaid programs, with CRC certification planned within one year and proficiency in Microsoft Office to aid documentation