The Risk Adjustment Coder performs quality assurance coding of medical records and ICD-10 diagnosis codes for submission to CMS and other government agencies. This role ensures coding accuracy and that all diagnoses are properly supported by clinical documentation in the health record.
Key responsibilities include reviewing medical records to identify conditions that map to HCCs, applying appropriate ICD-10 diagnosis codes, following state and federal regulations, and supporting projects that may involve contacting providers. The position requires independent judgment, strong communication skills, and comfort working with multiple software applications and digital tools.
Must hold at least one AAPC or AHIMA certification, such as:
- CPC or CPC-A
- COC
- CIC
- CRC
- CCA
- CCS
- CCS-P
Additional requirements:
- Experience in a goal-oriented, production- and quality-driven environment
- Ability to maintain annual continuing education requirements and remain in good standing with the credentialing body
- Availability to attend 3 weeks of virtual training, Monday-Friday, 8:00 AM-4:30 PM Eastern time
- Ability to work 40 hours per week Monday-Friday, with mandatory overtime as needed
- Dedicated confidential workspace free from distractions
- Proficiency with computers and multiple software applications
- Preferred: Microsoft Word and Excel proficiency, risk adjustment experience, and HCC coding experience
Humana offers a competitive benefits package 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 insurance
- Life insurance
Location
South Dakota, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$48,300 - $65,900
Remote work allowed
Yes
Posted
1 week ago