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Risk Adjustment Coder

Humana

Become a part of a caring community as a Risk Adjustment Coder responsible for quality assurance coding of medical records and ICD-10 diagnosis codes submitted to CMS and other government agencies.

The role ensures coding is accurate and supported by clinical documentation in the health record, with ownership of advanced and specialized administrative and operational tasks requiring independent initiative and judgment.

Key responsibilities include:

  • Review medical records to report conditions that map to HCCs by applying appropriate ICD-10 diagnosis codes.
  • Follow state and federal regulations, internal policies, and guidelines while analyzing coding information and medical records.
  • Work on projects that may include making phone calls to providers.
  • Operate within broad guidelines with little oversight.
  • Demonstrate professionalism, strong work ethic, reliability, and a positive team-oriented attitude.
  • Use computers and relevant technology effectively, including multiple software applications and digital tools.
  • Participate in special projects in addition to daily responsibilities.
  • Be available for mandatory overtime as needed to meet business needs.
Requirements & Qualifications

Required qualifications:

  • One of the following AAPC or AHIMA certifications is required:
    • CPC or CPC-A
    • COC
    • CIC
    • CRC
    • CCA
    • CCS
    • CCS-P
  • Experience in a goal-oriented environment that is production- and quality-driven.
  • Must maintain annual continuing education requirements and remain in good standing with the applicable credentialing body.
  • Ability to attend 3 weeks of virtual classroom training, Monday through Friday, 8:00 a.m. to 4:30 p.m. Eastern Time.
  • Ability to work 40 hours per week, Monday through Friday, with mandatory overtime as needed.
  • Must have a confidential workspace free from distractions.
  • Proficiency with relevant technology, including navigation of multiple software applications and digital tools.

Preferred qualifications:

  • Proficiency with Microsoft Word and Excel.
  • Risk adjustment experience.
  • HCC coding experience.

Work-from-home requirements:

  • Minimum internet speed of 25 Mbps download and 10 Mbps upload.
  • Dedicated work space with no ongoing interruptions to protect PHI and HIPAA information.
  • Occasional travel to Humana offices for training or meetings may be required.
Benefits & Perks

Humana offers competitive benefits, including:

  • Medical, dental, and vision insurance
  • 401(k) retirement savings plan
  • Paid time off
  • Company and personal holidays
  • Paid parental and caregiver leave
  • Short-term and long-term disability
  • Life insurance
  • Additional wellness and employee support opportunities

Location

Wyoming, 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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