CARR Analyst II

BlueCross BlueShield of Tennessee

. Research, design, analyze, recommend, implement, resolve problems, maintain, and coordinate coding and reimbursement activities .

Posted 10/9/2026full-timeRemote • Tennessee • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in facility coding and reimbursement, including proficiency in MS-DRGs, APCs, and regulatory compliance. Capable of conducting thorough research and analysis to support coding consultations and billing guidelines.

Highest-signal resume keywords

Facility Coding ExperienceMedical Coding CertificationClaims Processing KnowledgeAnalytical Problem-Solving SkillsProficiency in Microsoft Office

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Facility CodingReimbursement ResearchClaims EditingPayment Integrity ReviewsMS-DRGsAPCsRevenue CodesContract Reimbursement MethodologiesPayer Reimbursement SystemsMedical/Clinical Coding

Soft Skills

Analytical SkillsProblem-Solving SkillsOral Communication SkillsWritten Communication SkillsInterpersonal SkillsOrganizational Skills

Certifications & Qualifications

AAPC CPC/CPC-HAHIMA CCS-P/CCS

Industry Keywords

Claims ProcessingBilling GuidelinesPayment AccuracyComplianceHIPAA-standardized Claims TransactionsBlueCross BlueShield Reimbursement MethodologiesMedicare Provider ReimbursementHome Health Services

About the role

Key responsibilities & impact

Research, design, analyze, recommend, implement, resolve problems, maintain, and coordinate coding and reimbursement activities
Research and prepare coding and reimbursement policies, procedures, and billing guidelines
Coordinate data collection and administrative functions for coding, reimbursement, and billing changes
Advise on coding, reimbursement, and billing issues through corporate committees and workgroups
Assist in developing educational materials for staff training
Provide coding consultations for company administrative functions and reviews
Review, prioritize, prepare, and present recommended code-editing changes
Support facility coding and reimbursement across contract development, system configuration, code maintenance, medical policy implementation, claim editing, provider disputes, appeals, coding updates, and claims adjudication
Research complex coding and reimbursement issues and evaluate regulatory and industry changes
Collaborate with Claims, Provider Network Management, Medical Policy, Clinical Coding Review, IT, and Customer Service to support payment accuracy, compliance, and reimbursement solutions

Requirements

What you’ll need

Experience in facility coding and reimbursement, including inpatient and outpatient payment methodologies
Experience with claims processing, reimbursement research, regulatory guidance, claims editing, and payment integrity reviews
Strong analytical and problem-solving skills with ability to research and communicate complex reimbursement topics
Knowledge of MS-DRGs, APCs, revenue codes, facility billing requirements, contract reimbursement methodologies, and payer reimbursement systems strongly preferred
No sponsorship available
Bachelor's Degree or equivalent work experience required; equivalent experience is defined as 4 years of professional work experience in a corporate environment
3 years of experience with Medical/Clinical Coding
Coding certification from a nationally recognized coding organization required, such as AAPC CPC/CPC-H or AHIMA CCS-P/CCS; if not certified, must obtain certification within two years of hire
Ability to work independently with minimal supervision or in a team environment
Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint)
Ability to handle multiple projects
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Knowledge of claims, customer service, member benefits, authorization, reimbursement applications, and configuration
Knowledge of BlueCross BlueShield of Tennessee and Medicare provider reimbursement methodologies in at least one specialty area: Professional, Facility, or Home Health services
Basic knowledge of HIPAA-standardized claims transactions and medical/clinical coding