Capital Blue Cross promises to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”
Salary Distribution
7 of 8 jobs
$21
Min
$51,915
25th
$119,390
Median
$123,367
75th
$137,290
Max
Benefits Overview
8 of 8 jobs
Dental
(8)
Medical
(8)
PTO
(8)
Retirement Plan
(8)
Tuition Reimbursement
(8)
Vision
(8)
Holidays
(7)
Incentive Plan
(2)
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.