Blue Cross and Blue Shield of Kansas City · 5 hours ago
Revenue Integrity Analyst
2300 Main, Kansas City, MO
Full-time
Onsite
Mid Level
3+ years expBlue Cross and Blue Shield of Kansas City is committed to providing health and lifestyle benefits to ensure a best-in-class employee experience. The Revenue Integrity Analyst ensures accurate documentation, coding, and risk adjustment practices to support high quality patient care and optimize risk capture in a value-based model.
Association
Responsibilities
Manages revenue integrity support for physicians, Advanced Practice Providers (APPs) and other providers by providing education on documentation and coding to the highest level of service being rendered
Manages the complete revenue cycle for Spira Care Outpatient Services, which includes centralized functions such as coding, claims, and patient billing to improve efficiencies and ensure compliance
Ensures compliance by adhering to complex medical guidelines and payer rules
Collaborates across clinical operations and IT to ensure accurate and comprehensive clinical documentation that supports risk adjustment, quality performance, and value‑based reimbursement. Ensures documentation integrity by closing coding‑related gaps and maintains compliance within value‑based care models
Ensures accurate and compliant coding practices with emphasis on risk adjustment Hierarchical Condition Category (HCC), chronic condition management, and quality measure alignment
Partners with providers to improve documentation specificity and capture clinically relevant diagnoses that impact patient outcomes and value‑based performance
Provides education and feedback to providers on documentation best practices, risk score capture, documentation standards, and quality measure requirements to support accurate representation of patient complexity and care needs
Reviews coding, documentation, and quality performance data to identify trends, address deficiencies, and support accurate risk adjustment and quality reporting
Maintains adherence to compliance standards related to coding, documentation, risk adjustment, and quality programs. Ensures internal processes meet the expectations of value‑based programs
Supports internal and external audits related to documentation quality, HCC coding, and value‑based contract performance, working with providers and teams to implement corrective action plans when needed
Analyzes and ensures code drops are correct for all services rendered
Qualification
Required
High school diploma or equivalent (GED or HiSET)
Successful completion of a certified medical coding or auditing course and exam
CPC – Certified Professional Coder
CPMA - Certified Professional Medical Auditor
3-5 years of experience as a coder
Requires travel to all Spira Care areas (as needed)
Excellent interpersonal and communication skills
Solid computer skills, including proficiency with Microsoft software
Strong analytical and problem-solving skills
Detail-oriented
Preferred
Bachelor's degree in healthcare related field
CRC – Certified Risk Coder
Benefits
Comprehensive medical, dental and vision benefits
401(k) plan that both the employee and employer contribute
Annual incentive bonus plan based on company achievement of goals
Time away from work including paid holidays, paid time off and volunteer time off
Professional development courses, mentorship opportunities, and tuition reimbursement program
Paid parental leave and adoption leave with adoption financial assistance
Employee discount program
Company
Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Kansas City (Blue KC) is an independent licensee of the Blue Cross Blue Shield Association and a not-for-profit health insurance provider serving more than one million members in 32 counties in greater Kansas City and northwest Missouri and Johnson and Wyandotte counties in Kansas.
1001-5000 employees
H1B Sponsorship
Blue Cross and Blue Shield of Kansas City has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (4)
2023 (3)
2022 (3)
2021 (3)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Erin Stucky
President and CEO
Amber Mustard
Chief Technology Officer
Recent News
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