Risk Adjustment Medical Coder (CPC/CRC Certified)

Blue Cross of Idaho; Boise (ID); On-site; USD 36,000 - 50,000; Full time

Job summary

Blue Cross of Idaho is hiring a Risk Adjustment Medical Coder to support chart retrieval, coding, and audits for risk adjustment and revenue accuracy. The role requires 3+ years in healthcare with knowledge of HCC coding; CPC certification is required and CRC within one year.

You'll collaborate with cross-functional teams, review records, ensure CMS-compliant coding, and help develop risk adjustment tools and resources. A comprehensive benefits package and incentive bonus accompany the role.

Qualifications

• 3+ years of health industry experience including medical record coding.
• Experience with HCC and/or Risk Adjustment coding preferred.
• CPC certification required; CRC within one year of hire.

Responsibilities

• Perform initial and follow-up outreach to physician groups for chart procurement.
• Retrieve records via electronic and on-site methods.
• Review, code, and analyze medical records for HCC and risk adjustment.
• Ensure coding aligns with ICD guidelines and CMS rules.

Skills

Attention to detail

Communication skills

Microsoft Office

Coding proficiency (ICD CPT HCPCS)

Self-motivated / fast learner

Education

CPC certification

CRC certification within 1 year

Associate or Bachelor degree

Tools

EMR systems

HIPAA familiarity

Billing/claims systems

Job description

Blue Cross of Idaho is hiring a Risk Adjustment Medical Coder to support chart retrieval, coding, and audits for risk adjustment and revenue accuracy. The role requires 3+ years in healthcare with knowledge of HCC coding; CPC certification is required and CRC within one year.

You'll collaborate with cross-functional teams, review records, ensure CMS-compliant coding, and help develop risk adjustment tools and resources. A comprehensive benefits package and incentive bonus accompany the role.