Dec 12, 2025
CareFirst BlueCross BlueShield
Resp & Qualifications PURPOSE: The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk Adjustment Data Validation (RADV) audit and any other chart coding functions, by performing moderately complex medical record review and coding, ensuring compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines. The development and ongoing maintenance of the Risk Adjustment Coding guidelines, as well as, guiding junior coding specialists are included in the job responsibilities. ESSENTIAL FUNCTIONS: Verifies accuracy, completeness, and appropriateness of diagnosis codes based on medical documentation provided at all levels of complexity. Utilizes appropriate coding guidelines and recommends any changes to diagnosis codes based on chart review. Achieves and maintains coding accuracy levels greater than 90%. Works with vendors,...
Professional Diversity Network
Baltimore, MD, USA
Full-Time
