Risk Adjustment Coder

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 is accurate and supported by clinical documentation in the health record.

Responsibilities include:

• Review medical records to identify conditions that map to HCCs by applying appropriate ICD-10 diagnosis codes.
• Follow state and federal regulations as well as internal policies and guidelines when analyzing coding information and medical records.
• Work on projects that may include making phone calls to providers.
• Operate within broad guidelines with little oversight.
• Participate in special projects in addition to daily responsibilities.
• Work mandatory overtime when needed to meet business needs.

Training is conducted in a virtual remote classroom for the first 3 weeks. After training, the role works a 40-hour schedule Monday through Friday within the employee's own time zone, with occasional overtime. This is a remote position, though occasional travel to Humana offices for training or meetings may be required.