Blue Cross and Blue Shield of Vermont

Medical/Clinical Coding Specialist – Risk Adjustment | Full Time

Category: Insurance

Location: 445 Industrial Lane

Blue Cross and Blue Shield of Vermont is looking for a Medical/Clinical Coding Specialist to join our Risk Adjustment team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym (post-COVID), 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.

Medical/Clinical Coding Specialist Responsibilities:

  • Serve as the primary point of contact, consultative resource, and subject matter expert in all aspects of coding and medical record documentation requirements as they apply to Risk Adjustment.
  • Work directly with providers to build positive relationships, ensure effective education and reporting, proactively identify performance improvement opportunities through analysis and discussion with subject matter experts, and influence provider behavior to achieve necessary results.
  • Review medical records, identify gaps in care and provide education to providers and staff to ensure they are coding to the highest level of specificity.
  • Assist in educating providers and office staff, including assisting in the creation of trainings that relate to Risk Adjustment and Hierarchical Condition Category (HCC) best practices.
  • NOTE: This position may travel on average, up to 25 percent of the time.

Medical/Clinical 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-10-CM, ICD-10-PCS, HCPCS, DRG, as well as medical record documentation expertise.
  • Formal coding certification through the Academy of Professional Coders (AAPC) or the American Health Information Medical Association (AHIMA).
  • Experience with both professional and facility claims coding and with familiarity of Ambulatory Payment Classification (APC), Health Insurance Payment System (HIPPS), or Payment Driven Payment Model (PDPM) coding and validation.
  • Must be willing to successfully pass the AAPC Certified Risk Coder (CRC) and AHIMA Certified Documentation Improvement Practitioner certifications(CDIP) within a year of  hire– if not already completed and in good standing.

Medical/Clinical Coding Specialist Benefits:

  • Health insurance (including vision)
  • Dental coverage (free to employees)
  • Wellness Program
  • 401(k) with employer match
  • Life Insurance
  • Disability Insurance
  • Combined time off (CTO) – 20 days per year + 9 paid holidays
  • Tuition Reimbursement
  • Student Loan Repayment
  • Dependent Caregiver Benefits

*full job description attached to ADP posting


To Apply:

Visit us at to learn more and apply.