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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 is accurate and properly supported by clinical documentation within the health record.
The position involves independent work within broad guidelines, with responsibility for specialized administrative and operational duties. Work may include reviewing records for HCC mapping, applying ICD-10 diagnosis codes, following regulations and internal policies, and occasionally contacting providers. Associates may also participate in special projects and may be required to work mandatory overtime to meet business needs.
Training is conducted in a virtual classroom for the first 3 weeks. After training, the schedule is Monday through Friday for 40 hours per week within the associate's 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- and quality-driven environment
- Must maintain annual continuing education requirements and remain in good standing with AAPC or AHIMA
- Must be able to attend 3 weeks of virtual classroom training, Monday through Friday, 8:00 AM to 4:30 PM Eastern Time
- Must be able to work 40 hours per week, Monday through Friday, with mandatory overtime as needed
- Must have a confidential, distraction-free workspace
- Proficient with computers and relevant technology, including multiple software applications and digital tools
Preferred qualifications
- Proficiency with Microsoft Word and Excel
- Risk adjustment experience
- HCC coding experience
Work-from-home requirements
- Self-provided internet service with at least 25 Mbps download and 10 Mbps upload
- Dedicated workspace without interruptions to protect member 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
- 401(k) retirement savings plan
- Paid time off, company holidays, and personal holidays
- Paid parental and caregiver leave
- Short-term and long-term disability coverage
- Life insurance
- Additional wellness and family support benefits
Location
North Dakota, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$48,300 - $65,900
Remote work allowed
Yes
Posted
1 week ago