Risk Adjustment Coder

Blue Cross and Blue Shield of Kansas City(21 days ago)

HybridFull TimeMedior$78,521 - $105,903 (estimated)Risk Adjustment

About this role

Develops expert knowledge of CMS Commercial Risk Adjustment and Medicare Advantage rating models to support clinical coding programs and ensure accuracy and integrity of data submitted to CMS. Focuses on evaluating organizational programs to assess risk scores and star measure outcomes and identifying opportunities for improvement. Works within the health plan’s risk adjustment operations to advance coding quality and compliance.

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Required Skills

CMS-HCC
HHS-HCC
Medical Coding
ICD-10
Provider Queries
Data Reconciliation
Quality Assurance
Excel
MS Project
Clinical Documentation

+2 more

Qualifications

Bachelor's Degree
BSN
CPC
CRC (within 1 year)

About Blue Cross and Blue Shield of Kansas City

bluekc.com

Blue Cross and Blue Shield of Kansas City (Blue KC) is a health insurance provider dedicated to offering comprehensive health plans for individuals, families, and groups. With a focus on helping members live healthy and fearless lives, Blue KC provides a range of coverage options tailored to meet diverse needs. The company prides itself on being a trusted partner in health, renowned for its commitment to service and community engagement in the Kansas City area.

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