The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes submitted to CMS and other government agencies. This role ensures coding accuracy and appropriate clinical documentation support within the health record.
Key duties include reviewing medical records for conditions that map to HCCs, applying ICD-10 diagnosis codes, following state and federal regulations, supporting special projects, and occasionally contacting providers. The position requires independent judgment, strong communication skills, and comfort using multiple software applications and digital tools.
Required Qualifications
- One of the following certifications is required: CPC or CPC-A, COC, CIC, CRC, CCA, CCS, or CCS-P
- Experience working in a goal-oriented, production- and quality-driven environment
- Ability to maintain annual continuing education requirements and remain in good standing with AAPC or AHIMA
- Ability to attend a 3-week virtual classroom training, Monday-Friday, 8:00 AM to 4:30 PM Eastern Time
- Ability to work 40 hours per week, Monday-Friday, with mandatory overtime as needed
- Must have a confidential, distraction-free work space
- Proficiency using relevant technology and multiple software applications
Preferred Qualifications
- Microsoft Word and Excel proficiency
- Risk adjustment experience
- HCC coding experience
Work from Home Requirements
- Reliable internet service with at least 25 Mbps download and 10 Mbps upload speed
- Dedicated work space with no ongoing interruptions to protect PHI/HIPAA information
- Occasional travel to Humana offices for training or meetings may be required
Humana offers competitive benefits, including medical, dental, and vision coverage; a 401(k) retirement savings plan; paid time off; company and personal holidays; paid parental and caregiver leave; short-term and long-term disability; life insurance; and other wellness-related benefits.
Location
Indiana, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$48,300 - $65,900
Remote work allowed
Yes
Posted
1 week ago