The Medicare Advantage and Quality Management division drives performance in Medicare Advantage and the care and service delivered to members by focusing on health status, health outcomes, and experience.

The Certified Medical Record Coder is responsible for reviewing medical records from the Blue Cross and Blue Shield of Alabama member population to ensure correct coding, and communicating coding policies and procedures to staff. The primary responsibility of the Coder is the review provider and vendor medical records and health risk assessments to validate data within the medical records for accuracy in diagnosis codes and CPT codes. The Coder will capture diagnosis and CPT codes found within medical records. In addition to diagnosis code and CPT code validation, duties may include assisting with coding issues relating to policy development, documenting quality of medical records and health risk assessments, working with Senior Clinical Analysts to report coding accuracy by provider and responding to complex inquiries that require extensive coding knowledge.

• 2 years of experience as a Certified Coder
• Coding certification which may include one of the following: Certified Professional Coder (CPC), Certified Coding Specialist for Providers (CCS-P), Certified Risk Coder (CRC) Certified Coding Specialist for Hospitals (CCS-H), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA)
• Experience in support of projects according to assigned responsibilities
• Demonstrated knowledge of principles involved in professional coding
• Extensive training and knowledge of medical terminology, disease processes, and pharmacology
• Knowledge of Microsoft Office products
• Extensive knowledge of ICD-9/10, CPT, and CMS coding principles and guidelines, specifically Risk and HEDIS knowledge and experience
• Excellent written and verbal communication skills
• Strong attention to detail with excellent organizational skills
• Broad understanding of Medicare guidelines, regulations and claims processing procedures preferred
• Experience in a position researching and validating coding criteria preferred
• Bachelor’s degree preferred
• Certified Risk Coder (CRC) preferred

By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.
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Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association