Capital Blue Cross is committed to going the extra mile for their team and community. They are a caring team of supportive colleagues where your health and wellbeing are prioritized.
Salary Distribution
6 of 7 jobs
$21
Min
$22,783
25th
$97,440
Median
$115,495
75th
$119,390
Max
Benefits Overview
7 of 7 jobs
Dental
(7)
Medical
(7)
PTO
(7)
Retirement Plan
(7)
Tuition Reimbursement
(7)
Vision
(7)
Holidays
(6)
Incentive Plan
(3)
Volunteer time off
(1)
Responsible for coordination of services for members, emphasizing education/self-management and quality care. \n- Assesses member needs, reviews service options, develops and implements care plans, and coordinates resources. \n- Manages a caseload of moderate-high risk members with complex medical/behavioral/psychosocial needs.
Perform comprehensive review and oversight of medical records for Risk Adjustment compliance keeping with CMS and departmental guidelines with a 95%+ accuracy rate
Collaborates with a variety of internal and external clients, including health care executives, physicians, provider office personnel, and payer representatives from various health plans to streamline and optimize accurate diagnosis code capture.
Reviews medical records and billing history to determine if specific disease conditions were correctly billed and documented.