Coding Specialist - Medicare

Blue Cross and Blue Shield of North Carolina

3d • Hybrid

About The Position

We're seeking an experienced Coding Specialist to join the Clinical Coding Review Team within the Special Investigations Unit. In this role, you will use clinical and coding expertise to analyze medical records and charts in relation to provider coding. The Coding Analyst identifies physician practices with complex coding patterns and reports relevant data to the Centers for Medicare and Medicaid Services (CMS).

Requirements

• High school diploma or GED
• 3+ years of experience in related field.
• Certified Professional Coder

Nice To Haves

• Demonstrated experience with Medicare billing, auditing and coding

Responsibilities

• Analyze necessary documentation, including medical records/charts, and apply clinical coding expertise to evaluate appropriateness of provider coding and reports relevant data to the Centers for Medicare and Medicaid Services (CMS).
• Use all resources to ensure compliance and understanding of the CMS Hierarchical Condition Category (HCC) payment methodology.
• Develop and maintain professional working relationships with Medical Providers and their staff necessary to facilitate onsite review of medical records.
• Maintain documents for tracking audit results, status of reviews etc.

Benefits

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
• Work-life balance, flexibility, and the autonomy to do great work
• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution
• Based on annual corporate goal achievement and individual performance.
• $45,761.00 - $73,217.00

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED