Coding Specialist

🔥 14 hours ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $45.8k - $73.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Blue Cross NC

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC is a health insurance provider that offers a range of health plans and services to individuals and groups. The company focuses on delivering quality healthcare coverage and improving health outcomes for its members through innovative health programs and services. Blue Cross NC is committed to enhancing access to affordable healthcare while supporting the health and wellness of the communities it serves.

📋 Description

• Analyze medical records and charts in relation to provider coding • Identify physician practices with complex coding patterns • Report relevant data to the Centers for Medicare and Medicaid Services (CMS) • Analyze documentation and apply clinical coding expertise to evaluate provider coding appropriateness • Ensure compliance with and understanding of the CMS Hierarchical Condition Category (HCC) payment methodology • Develop and maintain professional working relationships with medical providers and their staff to facilitate onsite medical-record reviews • Maintain documents tracking audit results and review status

🎯 Requirements

• High school diploma or GED • 3+ years of experience in a related field • Certified Professional Coder • Experience reviewing and assigning medical codes, preferably in a health insurance, claims, payment integrity, or reimbursement environment • Strong understanding of Emergency Department (ED/ER) coding and medical claim review processes • Ability to work independently while maintaining high levels of productivity and accuracy • Demonstrated success in a fast-paced, production-oriented environment and adaptability to continuous change • Experience working under quality review standards with a focus on accuracy and compliance

🏖️ Benefits

• Work-life balance, flexibility, and autonomy • Medical, dental, and vision coverage • Health and wellness programs • Parental leave and support • Adoption and surrogacy assistance • Career development programs • Tuition reimbursement for continued education • 401k match including an annual company contribution • Annual Incentive Bonus • Paid Time Off (PTO)