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Risk Adjustment Coder

Humana

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 is responsible for ensuring coding accuracy and support through clinical documentation review within the health record.

The position involves reviewing medical records to identify conditions that map to HCCs, applying appropriate ICD-10 diagnosis codes, following state and federal regulations and internal policies, and supporting special projects as needed. The role operates within broad guidelines with limited oversight and may include occasional provider outreach by phone.

Requirements & Qualifications

Required qualifications

  • One of the following certifications from AAPC or AHIMA:
    • CPC or CPC-A
    • COC
    • CIC
    • CRC
    • CCA
    • CCS
    • CCS-P
  • Experience 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 through Friday, 8:00 AM to 4:30 PM Eastern Time
  • Ability to work 40 hours per week, Monday through Friday, with mandatory overtime as needed
  • A confidential, distraction-free work space
  • Proficiency with computers, multiple software applications, and digital tools

Preferred qualifications

  • Proficiency with Microsoft Word and Excel
  • Risk adjustment experience
  • HCC coding experience
Benefits & Perks

Benefits

  • Medical, dental, and vision coverage
  • 401(k) retirement savings plan
  • Paid time off, company holidays, paid parental leave, and caregiver leave
  • Short-term and long-term disability coverage
  • Life insurance

Location

Arizona, US

Employment Type

Full-time

Experience Level

Intermediate Level

Salary Range

$48,300 - $65,900

Remote work allowed

Yes

Posted

1 week ago

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