Analyst - RIDGG Commercial Risk Adjustment
Blue Cross Blue Shield of Michigan

Detroit, Michigan

Posted in Insurance


This job has expired.

Job Info


Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.

  • Support the development, coordination, and implementation of projects to enhance the overall efficiency of operational procedures, methods, controls, and performance.
  • Compile and analyze operational data to identify and resolve business problems.
  • Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
  • Provide leadership team with status updates on projects and issues.
  • Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures.
  • Create and present reports and presentations to display operational data and propose business changes.
  • Provide support to both internal departments and external entities by answering questions, supplying information and training.
  • Participate on special projects or workgroups as assigned.
"Qualifications"
  • Bachelor's Degree in a related field is preferred.
  • Two (2) years of experience in a related field is required.
  • Effective verbal, written communication and interpersonal skills.
  • Ability to work independently or in a team environment and interact with all levels of the organization.
  • Effective analytical and problem-solving skills to identify, evaluate, recommend and implement changes to processes or procedures to address problems and improve departmental effectiveness.
  • Organizational skills and ability to prioritize; must be able to coordinate multiple activities with varying timelines.
  • Proficient in Microsoft Office suites.
  • Ability to develop and maintain effective working relationships.
  • A completed Coding Certification preferred.
  • Associate's degree in medical coding, health information technology or another closely related field preferred.
  • Working knowledge and proficiency in medical terminology, anatomy and physiology.
  • Be familiar and proficient in basic and advanced ICD-10-CM, CPT and HCPCS coding, Medicare guidelines and compliance.
  • Experience and knowledge of HCC Coding and Risk Adjustment experience a plus.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.


This job has expired.

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