Medical Coder

Blue Cross of Idaho•Bozeman, MT

2d•$26 - $37•Hybrid

About The Position

Blue Cross of Idaho is looking for Risk Adjustment Medical Coder who will be responsible for the medical record retrieval and over-reads for audit project activities as they relate to risk adjustment and revenue accuracy. Collaborate and support cross-functional teams needed for various risk adjustment program efforts to ensure coding, documentation, and reporting accuracy. This position has preference to be based in Meridian Idaho and offers hybrid work location; potential consideration for working fully remote within a mutually acceptable location. #LI-Remote; #LI-Hybrid.

Requirements

3/+ years’ experience in health industry (healthcare and/or health insurance) to include medical record coding, preferably with HCC and/or Risk Adjustment coding experience
Certified Professional Coder (CPC)
In addition to CPC, must also hold, or acquire within one year of hire: Certified Risk Adjustment Coder (CRC)
Creative, critical, interpersonal, and analytical thinking skills with a strong attention to detail
Strong verbal and written communication, including presentation preparation/development
Communicate effectively and professionally with all levels of professionals both within the organization and with external organizations; can work with and support cross-functional teams in a fast-paced environment
Microsoft Office (Word, Excel, PowerPoint)
Proficient coding (ICD, CPT, and HCPCS) both professional and institutional, with proven track record of coding accuracy
Learns quickly and stays on-task through completion of assigned duties.
Task and results oriented; self-motivated to request or tackle additional work.
Follows verbal instructions and written policies and procedures

Nice To Haves

Certified Risk Adjustment Coder (CRC), at time of application
Clinical Certification (CNA, MA, or above)
Associate or Bachelor Degree
Proficient coding experience with ICD-10-CM, CPT and HCPS code sets
Billing/Claims submission
HIPAA guidelines
Medical terminology and abbreviations, anatomy, physiology, pathological process of diseases and basic pharmacological concepts
Electronic Medical Record (EMR) applications and contents
Standards of ethical coding as set forth by the American Academy of Professional Coders (AAPC)

Responsibilities

Monitors audit project activities to perform initial and/or follow-up outreach to physician groups and/or contracted vendors for chart procurement.
Researches and resolves non-retrievable chart case inventory.
Retrieves records via various electronic and on-site methods.
Reviews, interprets, audits, codes, and analyzes medical records, claims and encounter information as it pertains to Hierarchical Condition Categories (HCC).
Review’s vendor coding guidelines to ensure alignment with official ICD guidelines, CMS rules and regulations and the organizations policies and procedures.
Assists in the development of risk adjustment documentation, coding tools, and resources.