Carr Analyst II

Job Summary

CARR is seeking a Coding Analyst II to join the Ancillary Coding & Reimbursement team. This role is crucial for supporting coding and reimbursement processes across all business lines. Key responsibilities include ancillary claims review, supporting contract development, system configuration, code maintenance, medical policy, appeals, and billing guidelines.

Key Responsibilities

The Analyst will collaborate cross-functionally with Claims, Clinical Coding Review, Provider Operations, IT, and Network Management to:

• Support editing logic
• Manage provider disputes and appeals
• Oversee claim adjudication

This position also involves:

• Coding research
• Policy and procedure development
• Serving as a resource for coding-related inquiries and initiatives

Qualifications

Education

• Bachelor's Degree or equivalent work experience (4 years of professional corporate experience).

Experience

• 3 years of experience with Medical/Clinical Coding.

Skills & Certifications

• Required: Coding certification from a nationally recognized organization (e.g., AAPC - CPC or CPC-H, AHIMA - CCS-P or CCS).
• Willingness to obtain certification: If not currently certified, must obtain certification within two years of hire.
• Work Style: Ability to work independently with minimal supervision and collaboratively in a team environment.
• Technical Skills: Proficient in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint).
• Project Management: Organized and capable of handling multiple projects simultaneously.
• Communication: Excellent oral and written communication skills.
• Interpersonal Skills: Strong interpersonal and organizational skills.
• Industry Knowledge:
  • Understanding of claims, customer service, member benefits, authorization, and reimbursement applications/configuration.
  • Knowledge of BlueCross BlueShield of Tennessee and Medicare provider reimbursement methodologies for professional services, facility services, or home health services.
  • Basic understanding of HIPAA standardized claims transaction and medical/clinical data.

Additional Information

• Sponsorship: Not available for this role.
• Number of Openings: 1
• Worker Type: Employee
• Company: BCBST BlueCross BlueShield of Tennessee, Inc.

Equal Employment Opportunity: BCBST is committed to equal opportunity in all aspects of employment. For more information, please review BCBST's EEO Policies/Notices.

Search Firm Policy: BlueCross BlueShield of Tennessee does not accept unsolicited assistance from search firms for this employment opportunity.

About BlueCross BlueShield of Tennessee: As Tennessee's largest health benefit plan company, BCBST has been dedicated to the health and well-being of Tennesseans since 1945. We foster a culture of innovation, empowering employees to thrive both independently and collaboratively. We encourage the responsible use of AI-enabled tools to enhance our work and member service.

Remote Work Policy: BCBST is a remote-first organization. Positions are classified as fully remote, partially remote, or office-based. Remote positions are available across the U.S., with exceptions for California, Massachusetts, New Hampshire, New Jersey, and New York. Relocation assistance may be available for positions requiring residence in Chattanooga, TN.