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Risk Adjustment Coder

Humana

Conduct quality assurance coding of medical records and ICD-10 diagnosis codes submitted to CMS and other government agencies.

The role is responsible for ensuring coding accuracy and proper support within the health record, with ownership of advanced administrative and operational duties requiring independent judgment.

Core responsibilities include:

  • Reviewing medical records to identify conditions that map to HCCs and applying appropriate ICD-10 diagnosis codes
  • Following state and federal regulations, as well as internal policies and guidelines, while analyzing coding information and medical records
  • Performing project work that may include contacting providers by phone
  • Working within broad guidelines with minimal oversight
  • Participating in special projects in addition to daily responsibilities
  • Supporting timely completion of operational tasks, including occasional mandatory overtime when needed
Requirements & Qualifications

Required qualifications:

  • One of the following AAPC or AHIMA certifications:
    • CPC or CPC-A
    • COC
    • CIC
    • CRC
    • CCA
    • CCS
    • CCS-P
  • Experience in a goal-oriented, production-driven, and quality-driven environment
  • Ability to maintain annual continuing education requirements and remain in good standing with the credentialing body
  • Ability to attend a 3-week virtual training class, Monday through Friday, 8:00 AM to 4:30 PM Eastern Time
  • Ability to work 40 hours per week, Monday through Friday, with mandatory overtime as needed
  • Dedicated confidential workspace without distractions
  • Proficiency with relevant technology 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
  • 401(k) retirement savings plan
  • Paid time off, company holidays, and personal holidays
  • Paid parental and caregiver leave
  • Short-term and long-term disability
  • Life insurance
  • Additional wellness and family support benefits

Location

Kentucky, US

Employment Type

Full-time

Experience Level

Associate

Salary Range

$48,300 - $65,900

Remote work allowed

Yes

Posted

1 week ago

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