What are the responsibilities and job description for the Medical Coding Specialist position at BlueCross BlueShield of Vermont?
Blue Cross and Blue Shield of Vermont is looking for a Medical Coding Specialist to join our Payment Integrity team. Our company culture is built on an unwavering focus on the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401k, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.
LOCATION: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week.
Coding Specialist Responsibilities:
- Oversee maintenance of medical coding changes in our Payment Integrity programs
- Research requests using multiple systems (including: Sales Force, Jira, NPS) to provide all available details to reviewer
- Use SalesForce, Jira, and NASCO claim systems, to perform functions such as initial claim review, outcome reporting, and distribution based on triage
- Correspond with providers regarding decisions about requested services and obtain medical records when necessary
- Review and respond to issues and questions from internal and external customers, both verbally and in writing
- Work collaboratively with other departments to obtain additional information to resolve inquiries
Coding Specialist Qualifications:
- Bachelor’s degree, or equivalent combination of education and experience, with a minimum of 3 years’ experience in medical coding; In-depth knowledge of CPT, ICD-9, ICD-10, HCPCS, DRG diagnosis and procedure coding
- Formal coding certification (eg: CPC, AAPC) is a must
- Experience with both professional and facility claims coding and in APC, HIPPS, or RUG coding and validation
Coding Specialist Benefits:
- Health insurance (including vision)
- Dental coverage (free to employees)
- Wellness Program
- 401(k) with employer match automatic employer contribution
- Life Insurance
- Disability Insurance
- Combined time off (CTO) – 20 days per year 10 paid holidays
- Tuition Reimbursement
- Student Loan Repayment
- Dependent Caregiver Benefits
- Full job description attached to ADP job posting.
