Job Description
The Risk Adjustment Coding Oversight Specialist will conduct quality oversight audits pertaining to risk adjustment coding of both internal and external (vendor) coders. This includes appropriately reporting added or deleted diagnosis based on medical record review results, reporting QA findings and trends to Sr Coding Oversight specialist and/or manager, supporting departmental goals and vendor SLA requirements, and performing additional risk adjustment projects as needed. The ideal candidate will have a High-school Diploma or equivalent, a Current CPC or AHIMA CCS credential, a Current CRC Certification, and a minimum of two years recent experience in medical record review, risk adjustment, diagnosis coding and/or quality auditing.
About Blue Cross and Blue Shield of Nebraska
At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.