[Hiring] Risk Adjustment Medical Record Coder-2 @BlueCross BlueShield of Tennessee

Role Description

We are hiring a Risk Adjustment Medical Record Coder at BCBST! In this role, you will 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. You’ll play an important role in ensuring documentation accuracy while contributing to overall quality and compliance within the Risk Adjustment & Quality Division.

You will contribute to team success by:

• Working collaboratively in a remote environment
• Engaging in team chats
• Supporting peers as needed

Your proactive mindset and commitment to continuous learning will help you stay current in an evolving healthcare landscape while strengthening overall team capability.

To be successful in this position, you’ll bring:

• Strong attention to detail
• Coding expertise
• The ability to work independently

Ideal candidates will have experience in:

• HCC (Hierarchical Condition Category) coding, particularly within Medicare Advantage, ACA programs, and Medicaid programs

We foster a culture where innovation is encouraged, including using AI-enabled tools responsibly to support everyday work—guided by proven workflows, templates, and policies.

Note:

• This is a remote, day-shift position working standard shift hours; 8am-5pm ET
• Candidates should be comfortable working independently while maintaining strong engagement with the team

Qualifications

• Associates degree or equivalent work experience required (Equivalent experience is defined as 2 years of professional work experience)
• 1 year of progressive medical coding and health care experience required
• Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA)
• Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within one year after completed training
• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles, and accountability
• Proficient in Microsoft Office (Outlook, Word, Excel, and PowerPoint)
• Proven analytical and problem-solving skills and ability to perform non-routine analytical tasks
• Must be a team player, be organized, and have the ability to handle multiple projects
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Understanding of ICD-10 coding standards required

Requirements

• Maintain compliance with CMS risk adjustment diagnosis coding guidelines
• Perform comprehensive 1st pass reviews of medical records and physician assessment forms (HCC coding)
• Assist with the intake and quality assurance of medical records as necessary
• Perform or participate in special projects as directed by management
• ICD-10 Coding assessment is required

Company Description