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Coding Compliance Specialist

Blue Cross Blue Shield Chicago, IL
compliance medical medical records insurance health supervision compliance procedures cms icd9 payments corrections high school
March 15, 2023
Blue Cross Blue Shield
Chicago, IL
FULL_TIME

Position located in Chicago, IL @ BCBS HQBASIC FUNCTION: Under supervision, this position is responsible for researching and analyzing the medical records when there is a discrepancy in coding; validating the coding and supporting the department in the reporting of findings. This position audits medical records to ensure compliance with the organizations coding procedures and standards according to the CMS Coding Guidelines and Official ICD9 / ICD10 Coding Guidelines. Reviews insurance payments and denials and recommends coding corrections. JOB REQUIREMENTS: * High School Diploma or GED. * CPC Coding Certification * 2 years medical coding experience * Experience with process management * PC experience and skills to include Microsoft Office * Verbal and written communication skills * Analytical skills * Ability to travel 60% to 80% of the time to physicians office / clinics. PREFERRED JOB REQUIREMENTS: * Associate or Bachelor's degree * Experience in health insurance or health care setting * Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail Exchange business


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