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Risk Adjustment Coder

Humana

Become a part of Humana's caring community.

The Risk Adjustment Coder performs 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 is accurate and supported by clinical documentation within the health record.

The position involves advanced administrative, operational, and customer support responsibilities requiring independent initiative and judgment. It includes reviewing medical records for HCC mapping, applying ICD-10 diagnosis codes, following state and federal regulations, and participating in special projects. Some work may include phone calls to providers.

Training is virtual for the first 3 weeks. After training, the role follows a 40-hour Monday through Friday schedule within the employee's time zone, with occasional overtime as needed.

Requirements & Qualifications

Required Qualifications

  • One of the following certifications is required: CPC, CPC-A, COC, CIC, CRC, CCA, CCS, or CCS-P
  • Experience in a goal-oriented, production- and quality-driven environment
  • Must 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 a.m. to 4:30 p.m. Eastern Time
  • Ability to work 40 hours per week, Monday-Friday, with mandatory overtime as needed
  • Must have a confidential, distraction-free workspace
  • Proficiency with computers and multiple software applications

Preferred Qualifications

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

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, and life insurance.

Location

Iowa, 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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