Remote Risk Adjustment Coding Specialist

Remote Jobs; United States; Hybrid; USD 52,000 - 95,000; Full time

Job summary

CareFirst BlueCross BlueShield is seeking a Risk Adjustment Coding Specialist to support retrospective risk adjustment, RADV audits, and related coding functions from a remote location within the Baltimore/Washington metropolitan area. Periodic in-person meetings at CareFirst sites are expected.

The role requires 3 years of risk adjustment/HCC coding experience, an RHIT/RHIA preference, and credentials such as CCS/CPS/CCS-P/CRC.

Qualifications

• Associate degree in Health Information Technology or related field, or 2 years additional experience in lieu of degree.
• CCS-C, CPS, CCS-P or CRC at hire; RHIT or RHIA preferred.
• 3 years risk adjustment/HCC coding experience.

Responsibilities

• Verify accuracy and completeness of diagnosis codes across varied complexity levels.
• Develop and maintain Coding guidelines for Commercial Risk Adjustment.
• Provide guidance to junior staff and coordinate with leadership and vendors.

Skills

Adobe Acrobat

MS Word

MS Excel

MS Outlook

Claims Processing

Facets

EMR/EHR platforms

customer service

Education

Associate's Degree in Health Information Technology

Associate's Degree in Business

2+ years relevant work experience

Tools

RHIT

RHIA

CCS-Coding Specialist

CCS-P

CRC

Job description

CareFirst BlueCross BlueShield is seeking a Risk Adjustment Coding Specialist to support retrospective risk adjustment, RADV audits, and related coding functions from a remote location within the Baltimore/Washington metropolitan area. Periodic in-person meetings at CareFirst sites are expected.

The role requires 3 years of risk adjustment/HCC coding experience, an RHIT/RHIA preference, and credentials such as CCS/CPS/CCS-P/CRC.