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The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. This role ensures coding accuracy and that documentation properly supports the health record.
Key responsibilities include reviewing medical records, applying ICD-10 diagnosis codes that map to HCCs, following state and federal regulations, working on special projects, and occasionally making calls to providers. The position requires strong communication skills, professionalism, and the ability to work independently with little oversight.
Training is conducted virtually for the first 3 weeks, Monday through Friday from 8:00 a.m. to 4:30 p.m. Eastern Time. After training, the role is a 40-hour workweek, Monday through Friday, within your own time zone, with occasional overtime as needed.
Required qualifications
- One of the following certifications is required:
- CPC or CPC-A (AAPC)
- COC (AAPC)
- CIC (AAPC)
- CRC (AAPC)
- CCA (AHIMA)
- CCS (AHIMA)
- CCS-P (AHIMA)
- Experience working in a goal-oriented, production-driven, quality-focused 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 a.m. to 4:30 p.m. Eastern Time
- Ability to work 40 hours per week Monday through Friday, with mandatory overtime as needed
- Must have a confidential, distraction-free workspace
- Proficiency with computers and multiple software applications
Preferred qualifications
- Proficiency with Microsoft Word and Excel
- Risk adjustment experience
- HCC coding experience
Work-at-home requirements
- Reliable internet service with at least 25 Mbps download and 10 Mbps upload
- Dedicated workspace with no ongoing interruptions to protect PHI/HIPAA information
Humana offers competitive benefits, including:
- Medical, dental, and vision coverage
- 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
Location
Missouri, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$48,300 - $65,900
Remote work allowed
Yes
Posted
1 week ago