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Job Overview
Location
Tennessee, USA
Job Type
Full-time
Category
Software Engineering
Date Posted
October 14, 2025
Full Job Description
đź“‹ Description
- • Own the end-to-end process of acquiring, validating, and uploading critical medical records into BCBST’s proprietary risk-adjustment coding platform. Every chart you process directly influences the accuracy of member risk scores and, ultimately, the affordability and quality of care delivered to more than 3.5 million Tennesseans.
- • Build and nurture trusted relationships with physician practices, hospitals, and ancillary providers across the state. You will schedule retrieval appointments, explain record requirements, and serve as the friendly, knowledgeable face of BCBST—turning compliance into collaboration.
- • Execute rigorous quality-assurance checks on every document you receive. You will verify member identity, confirm encounter dates, and ensure that each record meets CMS and internal standards before it is linked to the correct chart ID and released to our coding teams.
- • Leverage advanced EMR navigation skills to extract discrete data sets and large imaging files. Whether you are pulling a single progress note or an entire radiology study, you will maintain strict HIPAA protocols while optimizing file formats for downstream analytics.
- • Partner with Risk Adjustment leadership on ad-hoc projects—ranging from targeted chart chases for high-value conditions to pilot programs that test new retrieval technologies. Your insights will shape the next generation of retrieval workflows.
- • Maintain a real-time dashboard of pending, in-process, and completed requests. You will proactively flag delays, escalate provider issues, and recommend process improvements that reduce turnaround time and enhance provider satisfaction.
- • Serve as the first line of defense against missing or incomplete documentation. By auditing daily queues and running exception reports, you will ensure that no member condition goes uncaptured and no revenue is left on the table.
- • Champion a culture of continuous learning within the team. You will share EMR shortcuts, scheduling best practices, and QA tips during weekly huddles, elevating the collective expertise of the entire Risk Adjustment Medical Record Retrieval unit.
- • Uphold BCBST’s remote-first ethos by collaborating seamlessly across Microsoft Teams, SharePoint, and OneDrive. You will model digital-first productivity while maintaining the human touch that providers value.
🎯 Requirements
- • High-school diploma or equivalent and at least one year of hands-on administrative experience in a physician practice, hospital, health plan, or similar clinical setting
- • Demonstrated proficiency navigating Electronic Medical Record (EMR) systems such as Epic, Cerner, or NextGen to locate, export, and upload clinical documentation
- • Proven ability to schedule complex appointments and manage provider calendars via Outlook or equivalent tools while juggling competing priorities
- • Advanced Microsoft Office skills—particularly Outlook, Word, Excel, and PowerPoint—for communication, tracking, and reporting
- • Exceptional interpersonal and written communication skills that foster trust with providers and enable clear, concise hand-offs to coding teams
🏖️ Benefits
- • Remote-first flexibility—work primarily from home anywhere in the U.S. (excluding CA, MA, NH, NJ, NY) with potential relocation assistance for Chattanooga-based roles
- • Comprehensive health, dental, and vision coverage for you and eligible dependents starting day one
- • 401(k) with generous company match and additional annual discretionary contribution to support long-term financial wellness
- • Paid time off, volunteer days, and 11 observed holidays to recharge and give back to your community
- • Career-long learning opportunities including tuition reimbursement, internal certifications, and access to LinkedIn Learning and other professional development platforms
Skills & Technologies
Remote
About BlueCross BlueShield of Tennessee
BlueCross BlueShield of Tennessee is the largest health-benefit plan company headquartered in the state, providing medical, dental, vision, and Medicare Advantage coverage to individuals, employers, and government programs. Founded in 1945 as a nonprofit mutual insurance company, it administers benefits for more than 3 million members through statewide provider networks, care-management programs, and digital health services. The company also engages in community health initiatives, preventive-care outreach, and value-based reimbursement models to improve outcomes and manage costs across Tennessee.
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