Risk Adjustment Medical Record Coder-2

BlueCross BlueShield of Tennessee; Chattanooga (TN); Remote; USD 60,000 - 80,000; Full time

Job summary

BlueCross BlueShield of Tennessee (BCBST) is hiring a Risk Adjustment Medical Record Coder to support accurate coding practices by performing first-pass reviews of member medical records to map active conditions to risk values. The role emphasizes independent work in a remote environment with 8am-5pm ET hours.

Ideal candidates have HCC coding experience in Medicare Advantage, ACA, and Medicaid programs, with ongoing CRC certification and proficiency in Microsoft Office.

Qualifications

• Associates degree or 2 years of professional experience required.
• 1 year progressive medical coding and healthcare experience required.
• Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA) preferred.
• Must acquire the CRC (Certified Risk Adjustment Coder) certificate within one year of training.

Responsibilities

• Maintain CMS risk adjustment diagnosis coding guidelines compliance.
• Perform comprehensive first-pass reviews of medical records and physician assessment forms (HCC coding).
• Assist with intake and quality assurance of medical records as needed.
• Participate in special projects as directed by management.
• ICD-10 coding assessment is required.

Skills

HCC coding

AHIMA/AAPC certification

Communication skills

Education

Associates degree or equivalent

Tools

Microsoft Office

Job description

Risk Adjustment Medical Record Coder

We are hiring a Risk Adjustment Medical Record Coder at BCBST! In this role, you will support accurate and compliant coding practices by performing first-pass reviews of member medical records to identify and capture active conditions that map to risk values. You'll play an important role in ensuring documentation accuracy while contributing to overall quality and compliance within the Risk Adjustment & Quality Division.

You will contribute to team success by working collaboratively in a remote environment, engaging in team chats, and supporting peers as needed. Your proactive mindset and commitment to continuous learning will help you stay current in an evolving healthcare landscape while strengthening overall team capability.

To be successful in this position, you'll bring strong attention to detail, coding expertise, and the ability to work independently. Ideal candidates will have experience in HCC (Hierarchical Condition Category) coding, particularly within Medicare Advantage, ACA programs, and Medicaid programs.

We foster a culture where innovation is encouraged. That includes using AI-enabled tools responsibly to support everyday work—guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to enhance accuracy, efficiency, and outcomes.

Note: This is a remote, day‑shift position working standard shift hours; 8am-5pm ET. Candidates should be comfortable working independently while maintaining strong engagement with the team.

Job 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.

Job Qualifications

Education

• Associates degree or equivalent work experience required. Equivalent experience is defined as 2 years of professional work experience.

Experience

• 1 year - Progressive medical coding and health care experience required.

Skills/Certifications

• Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA).


• Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within one year, after completed training.


• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.


• 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 have the ability to handle multiple projects.


• Excellent oral and written communication skills.


• Strong interpersonal and organizational skills.


• Understanding of ICD-10 coding standards required.

Number of Openings Available: 1

Worker Type: Employee

Company: BCBST BlueCross BlueShield of Tennessee, Inc.

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices