Blue Cross and Blue Shield of Kansas is looking to add to our Risk Adjustment team and has an opportunity for a Risk Adjustment Coding and Outreach Specialist. This position will be responsible for the ICD-10-CM diagnosis code capture for Affordable Care Act (ACA) and Medicare Risk Adjustment initiatives to include CMS required Medicare and Commercial Risk Adjustment and Risk Adjustment Data Validation (RADV) audits. The responsibilities of this position significantly impact the company's risk adjustment revenue opportunities. This position will retrieve, review, and analyze medical records for documentation to substantiate the medical diagnosis codes submitted on claims. Activities also include member and provider communication and education, scheduling, and process performance measurement to support closing both risk adjustment and quality care gaps. This position is in a fast-paced, developing area.
"This position is eligible to work remotely (8 or less days a month onsite) or hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment."
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