BlueCross BlueShield of Tennessee logo
BlueCross BlueShield of Tennessee

Bringing peace of mind through better health to our customers and communities

Risk Adjustment QA Coordinator

QA EngineerQA EngineerFull TimeRemoteJuniorTeam 5,001-10,000Since 1952H1B SponsorCompany SiteLinkedIn

Location

Tennessee

Posted

34 days ago

Salary

Not specified

Seniority

Junior

Associate Degree1 yr expExperience acceptedEnglish

Job Description

• Perform quality assurance reviews on risk adjustment data submitted to CMS. • Evaluate coding accuracy using ICD‑10 Guidelines and internal policies. • Provide constructive, compassionate, and actionable feedback to coders. • Partner with leadership to identify trends and recommend quality improvements. • Support the development of educational materials and training initiatives. • Contribute to overall compliance and documentation integrity.

Job Requirements

  • Associates degree in related healthcare field or equivalent years of experience
  • 1 year - Progressive medical coding and health care experience required
  • Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA)
  • Proficient in MicroSoft Office (Outlook, Word, Excel, Access and PowerPoint)
  • Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within one year after completed training

Benefits

  • Health insurance
  • Flexible work arrangements
  • Professional development opportunities

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