Job Description
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).
What You'll Do
- 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.
What You Bring
- High school diploma or GED
- 3+ years of experience in related field.
- Certified Professional Coder
Bonus Points (Preferred qualifications)
- Demonstrated experience with Medicare billing, auditing and coding
What You’ll Get
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
#LI-Hybrid
Salary Range
At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.
*Based on annual corporate goal achievement and individual performance.
$45,761.00 - $73,217.00
Skills
Clinical Documentation, Clinical Documentation Review, ICD Coding, Medicaid, Medical Billing and Coding, Medical Documentation, Medical Insurance Coding, Medical Record Analysis, Medical Records Management, Medicare
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.
