BCBSM, Inc.

Blue Cross and Blue Shield of Minnesota is looking for a Risk Adjustment Coding Auditor. The role ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices. Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements. Performs retrospective and prospective chart reviews to ensure accurate risk adjustment reporting. Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider‑reported diagnosis codes based on medical record documentation. Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories. Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with...