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Risk Adjustment Medical Record Coder

BlueCross BlueShield of Tennessee

We are hiring a Risk Adjustment Medical Record Coder to 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.

This role contributes to documentation accuracy and overall quality and compliance within the Risk Adjustment & Quality Division. The position is remote, day shift, and requires strong collaboration with the team while working independently.

Key responsibilities include:

  • Maintaining compliance with CMS risk adjustment diagnosis coding guidelines
  • Performing comprehensive first-pass reviews of medical records and physician assessment forms for HCC coding
  • Assisting with intake and quality assurance of medical records as needed
  • Participating in special projects as directed by management
  • Supporting the use of AI-enabled tools responsibly within established workflows and policies
Requirements & Qualifications

Required qualifications:

  • Associate degree or equivalent work experience
  • 1 year of progressive medical coding and healthcare experience
  • Professional coding certification from AHIMA or AAPC such as CPC, CCS, RHIT, or RHIA
  • Ability to obtain the AAPC Certified Risk Adjustment Coder (CRC) credential within one year after training
  • Understanding of ICD-10 coding standards
  • Passing ICD-10 coding assessment
  • Proficiency with Microsoft Office, including Outlook, Word, Excel, and PowerPoint
  • Strong analytical, problem-solving, organizational, and communication skills
  • Ability to work independently with minimal supervision and collaborate effectively in a team environment

Location

N/A

Employment Type

Full-time

Experience Level

Associate

Remote work allowed

Yes

Posted

1 week ago

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